Mohs-Mikrographische Chirurgie: Risiken, Komplikationen und Risikominderung

Mohs surgery is the gold standard for high-risk non-melanoma skin cancers (basal cell, squamous cell), offering 99%+ cure rates with maximal tissue preservation. As with any surgery, risks exist:

Potential Complications

• Scarring – Inevitable; extent depends on tumor size, location, and reconstruction method (primary closure, flap, graft). Surgeons minimize visibility via relaxed skin tension lines and meticulous technique.
• Infection – Low risk (<2%); prophylactic antibiotics for high-risk sites/patients.
• Bleeding/hematoma – Usually controlled with pressure; occasionally requires return to OR.
• Nerve injury – Temporary or permanent sensory/motor deficit; rare with careful dissection.
• Recurrence – <1% for primary BCC/SCC; slightly higher for recurrent/aggressive subtypes.
• Wound dehiscence / graft failure – Higher in smokers, diabetics, irradiated fields.

Risk Mitigation

• Choose a fellowship-trained Mohs surgeon (ACMS member).
• Disclose all medications (anticoagulants, supplements).
• Stop smoking ≥4 weeks pre/post-op.
• Follow wound care instructions precisely.

Most patients experience uncomplicated healing with excellent cosmetic and oncologic outcomes.