Patient-centered perioperative interventions for mohs micrographic surgery: a systematic review

Mohs Micrographic Surgery (MMS) is the gold standard surgical treatment for cutaneous malignancies, distinguished by its high cure rates and tissue-sparring approach. Patient satisfaction is an increasingly recognized indicator of care quality in dermatology, and a growing body of literature has sought to identify interventions that enhance the MMS experience. We conducted a systematical review of perioperative interventions implemented during MMS and evaluated their effects on patient satisfaction. This systematic review was conducted in accordance with PRISMA guidelines. PubMed was searched using terms related to MMS and patient satisfaction, with eligible articles restricted to those implementing perioperative interventions and measuring patient satisfaction. Sources last accessed December 1, 2025. Nineteen publications spanning January 1999 to August 2025, encompassing 3,494 patients met criteria. Risk of Bias assessment used NIH’s Quality Assessment Tool. Included studies comprised 15 randomized control trials, three retrospective observational studies, and one comparison study. Patient satisfaction was uniformly high across interventions, regardless of treatment, consistent with ceiling effect attributable to the high baseline satisfaction observed in MMS populations. Four interventions demonstrated statistically significant improvement in patient satisfaction: education using 3D printed anatomical models, viewing of the surgical defect prior to closure, electrocautery smoke evacuation, and postoperative oral wound healing supplementation. Although most interventions did not significantly improve satisfaction, several demonstrated clinical value through improvements in anxiety reduction, patient preparedness, and complication detection. Future research should prioritize adequately powered, multicenter trials employing standardized satisfaction instruments and isolating interventions to more precisely characterize their contributions to the MMS experience.

Abstract from Crossref