Mohs Micrographic / PDEMA (formerly CCPDMA) Surgery

Developed over 80 years ago by Dr Frederic Mohs, this procedure remains the most advanced surgical method of skin cancer removal. With cure rates that are higher than any other skin cancer removal technique, you can be assured that there is an excellent chance that all the cancerous tissue will be removed. PDEMA (Peripheral and Deep En Face Margin Assessment) surgery is very similar to the Mohs procedure. However a separate pathologist will read the slides for the surgeon – whereas in a Mohs procedure, the specialist in question serves as both surgeon and pathologist.

If your skin cancer is being treated with Mohs surgery or PDEMA, these are the primary elements to be aware of going in:

• Local anaesthesia with our without sedation or general anaesthesia
• Surgical excision of cancerous tissue
• Microscopic examination of cut surfaces
• Higher cure rates than with standard excision
• Smaller defects than with standard excision
• Same day repair

Our Mohs micrographic / PDEMA surgeons are specially trained in this technique and perform both the surgery and the reconstruction. Because these methods require the surgeon to have highly specialised training, specific surgical and laboratory facilities and specialised personnel, few medical centres are equipped to offer such treatment. Skin Institute is one of the few medical centres equipped and staffed with skilled personnel to offer these techniques, which boast the highest cure rates for skin cancer.

Because of the complex training and equipment needed to carry out the surgery, it’s a very specialised procedure – one that we are proud to be able to offer.

More treatment details in our handbook available in clinics.

Mohs or PDEMA surgery at Skin Institute is performed as a day case procedure with local anaesthesia used at the treatment site. Depending on the extent of the surgery, sedation or general anaesthesia may be used.

The surgeon will excise all the cancerous tissue, and use a highly specialised technique and microscopic assessment of the tissue margins (all the surfaces that have been cut). This allows the surgeon to confirm complete removal of any skin cancer present, prior to closing the wound.

All our surgeons are trained in reconstructing the skin defects and repair the defects the same day.

Mohs micrographic / PDEMA surgery is the best method of removing skin cancer and ensuring at the time of the procedure that the skin cancer is completely excised. Mohs micrographic / PDEMA surgery has the highest cure rates for skin cancer and optimises the end cosmetic result.

Mohs micrographic / PDEMA surgery is used primarily to treat BCCs and SCCs but can also be used to treat less common tumours, including melanoma. Mohs micrographic surgery is indicated when:

• The cancer was treated previously and recurred
• Scare tissue exists in the area of the cancer
• The cancer is in a difficult area where it is important to preserve healthy tissue for a maximum functional and cosmetic result, such as eyelids, nose, ears and lips
• The cancer is large
• The edges of the cancer cannot be clearly defined
• The cancer grows rapidly or controllably