Mohs Micrographic Surgery in the Australian Public Health System: A Retrospective Observational Study and Review of the Australian Literature

ABSTRACT Background/Objectives Mohs micrographic surgery (MMS) is integral to skin cancer management due to its benefits in margin control and tissue conservation. In Australia, it is predominantly performed in the private setting, with Royal North Shore Hospital being the sole provider in the public system. This study presented an analysis of MMS within the Australian public health system and a review of local literature. Methods Conducting a retrospective chart review, we examined patients undergoing MMS between January 2018 and December 2022. Data encompassed patient demographics, tumour characteristics and surgical outcomes. Four electronic databases were searched for Australian literature on MMS. Results A total of 344 MMS procedures involving 299 patients were conducted at anonymised. Patients averaging 66.4 years of age (range 19–92 years) predominantly presented with basal cell carcinomas (92.2%) and squamous cell carcinomas (6.4%). 98.2% of tumours were found on the head and neck, genitalia, hands, digits and below the knee. The mean standard deviation (SD), pre‐operative tumour and defect sizes were 1.75 cm SD 1.01 and 2.30 cm SD 1.35 in maximum diameter, respectively. Our tumour and defect sizes were smaller compared to MMS procedures conducted in the public system 30 years ago. Review of local literature resulted in 11 relevant studies, of which 10 came from the private setting. Conclusions This study provided crucial insights into MMS referral patterns, utilisation and outcomes, demonstrating that the use of MMS aligns with local and international best practice.