key: cord-0714320-dv6fw08v
authors: Nicholson, P.; Ali, F.R.; Mallipeddi, R.
title: Impact of COVID‐19 on Mohs micrographic surgery: UK‐wide survey and recommendations for practice
date: 2020-06-27
journal: Clin Exp Dermatol
DOI: 10.1111/ced.14356
sha: d0cafdc9a916b232dab117b20bdf59ac060a37bd
doc_id: 714320
cord_uid: dv6fw08v

Coronavirus Disease 2019 (COVID‐19) pandemic has overwhelmed and disrupted healthcare systems including dermatology services. National directives were issued to reduce patient footfall within hospitals in anticipation of a deluge of COVID‐19 admissions. We conducted a survey focusing on the impact of the pandemic upon Mohs micrographic surgery (MMS) practices and invited all British Society for Dermatological Surgery (BSDS) members undertaking MMS to complete over three weeks commencing 27(th) April 2020.

This article is protected by copyright. All rights reserved Coronavirus Disease 2019 (COVID-19) pandemic has overwhelmed and disrupted healthcare systems including dermatology services. National directives were issued to reduce patient footfall within hospitals in anticipation of a deluge of COVID-19 admissions 1 . We conducted a survey focusing on the impact of the pandemic upon Mohs micrographic surgery (MMS) practices and invited all British Society for Dermatological Surgery (BSDS) members undertaking MMS to complete over three weeks commencing 27 th April 2020. Our findings are relevant for the restoration of MMS services and in preparation for a 'second spike' of COVID-19 cases or future pandemics.

We received 47 responses (estimated 52% response rate; there are an estimated 90 Mohs surgeons in the UK. We appreciate that there may be duplication if more than one member from the same department answered the survey, however practices can vary between clinicians within a department). In the majority of departments (77%) doctors and nurses were redeployed to intensive care and medical wards. As a direct consequence, 49% reported MMS services ceased; 36% and 15% reported reduced and normal services respectively. Free-text responses questioned whether the respondent felt that the level of redeployment was necessary or excessive (and at a cost to cancer services). Clinicians also highlighted MMS was suspended due to lack of personal protective equipment (PPE). There was confusion around aerosol generating procedure PPE and concerns the virus may persist in fresh frozen tissue (a risk for laboratory staff). 96% of respondents continuing with MMS rationalised patients by considering high risk tumours, comorbidities, age and patient choice. reported an increase. 40% reported they were not reviewing patients for Mohs surgery consultations/ follow-up appointments and of those who were reviewing, 79% were seeing fewer patients. Not

This article is protected by copyright. All rights reserved surprisingly, 91% reported a decrease in face-to-face consultations; 86% and 50% reported an increase in telephone and video consultations respectively. 

Advice for dermatology HCPs during Covid-19 pandemic. COVID-19 guidance for dermatology departments

British Association of Dermatologists and British Society for Dermatological Surgery

COVID-19 -Skin cancer surgery guidance. Clinical guidance for the management of skin cancer patients during the coronavirus pandemic