Mohs micrographic surgery (MMS) is recognized as the goldstandard treatment for high-risk nonmelanoma skin cancers (NMSC) of the head and neck. Given the rising incidence of skin cancer, the past two decades have seen a rapid increase in the number of centres providing this service in the U.K. However, data on the safety, complication rates and patient acceptance of MMS in the U.K. are lacking. Over a 3-month period (September to November 2012) eight regional MMS centres collected data that included tumour site, number of stages to clearance, method of reconstruction and intra-and postoperative complications. In addition to collecting basic demographic and medical information, patients were also asked to rate, on a 10-point Likert scale, (i) their perceived anxiety levels preoperatively, (ii) how well they tolerated the surgery on the day, and (iii) when followed up, their overall acceptance of having undergone MMS under local anaesthesia (LA). Data on 565 patients were analysed. There were 278 women and 287 men, with a median age of 67 years (range 28-93 years). The majority of lesions treated were NMSC (98%). The average number of stages to tumour clearance was 1Á3 (range 1-5). Overall, 60% of patients were clear of tumour within one stage and 34% in two stages, with 6% requiring three or more stages. On average, patients were able to leave the department a little over 4 h after commencing treatment. In total, 88% of all reconstructions (including large flaps and interpolated flaps) were performed on the day by the Mohs surgeon. No major peri-or postoperative complications occurred. Although trouble-

The use of Slow Mohs formalin-fixed tissue and H&E section staining, even with comparator biopsies, does not provide sufficient discrimination to identify residual disease confidently.

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