1. Surviving without mohs surgery in the skin cancer arena.
American society for Mohs surgery
XIII Annual clinical symposium
Williamsburg, Virginia, May 22-25, 2008.
Giovanni Schiavone, M.D. – Plastic surgeon, Rome,Italy:
Lecture:
Surviving without mohs surgery in the skin cancer arena.

2. Subtitle:
News from the Italian front in the common battle again skin cancers.

3. Goal of this presentation:
show you the way we approach our everyday practice.
Focus on some of the most common problems .
Give some practical tips on what we’ve learned
in the last 20 years.

7. Our heritage.

8. Mohs surgery: Our opinion.
Delivers the best cure rate in the treatment of skin cancer.
Indications effective in the most dangerous cases.
Preserves the surgeon from the “let’s start all over again” nightmare.
Gives the patient the “your cancer is out” effect.

9. Why Mohs didn’t take in europe.
A few dermathopathologists, no surgical formation.
Lack of knowledge.
Cost-effectiveness not understood.
Team work made difficult.

11. When you lead with delayed tissue repair:
Scar retraction could even work for you!

21. Tip # 1-Same approach different solutions.
Evaluate the (subtle) differences between apparently similar cases. This will lead you to different methods of repairing and presumably a better result.

24. Peroperatorio francioli

25. Pre post francioli

33. Tip #2 : look around the defect
there is often more skin than you probably expected if you only can figure it out where it is !

42. But please….
Move it in the proper way along the right axis.

46. Tensione ,

48. Tip # 3. Replace a problem with an opportunity.
Take advantage of the reconstructive procedures to give the patient a better aesthetic facial outcome.

50. Intra direct hemitip