Dr. Johann de Wet is a fellowship trained Mohs Micrographic Surgeon through the American Society of Dermatological Surgery.
Mohs micrographic surgery is a specialised form of skin cancer surgery in which cure rates close to 100% are achieved with minimal tissue removal. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. The goal of Mohs surgery is to remove the skin cancer, while causing minimal damage to surrounding healthy tissue.
International guidelines on skin cancer treatment recommend Mohs micrographic surgery as first line treatment and gold standard for skin cancer at high risk for recurrence and at cosmetically sensitive and/or functionally important areas.
It has been proven to provide the highest cure rates, being the most cost-effective and associated with best cosmetic outcomes when treating skin cancer.
With this technique, performed in most cases under local anaesthetic, the tumour is removed with a thin layer of surrounding healthy tissue. The removed tissue is then processed immediately by the Mohs surgeon (a dermatologist specially trained in Mohs micrographic surgery) in a Mohs histological laboratory on site, while the patient returns to the ward.
The specific method of processing allows tissue slides to be produced that shows the whole, complete cut surface around the tumour. These slides are then examined by the Mohs surgeon and will show very accurately any remaining tumour, including the exact area on the tumour wound where the tumour is still present.
The patient then returns to the day theatre and the process is repeated, but only on the area of the remaining tumour, leaving the healthy tumour-free part of the wound alone. As soon as the Mohs surgery confirms the skin cancer to be completely removed, a specialist reconstructive surgeon or the Mohs surgeon repairs the defect where the cancer was removed, almost always on the same day.
Dr de Wet offers Mohs surgery to suitable candidates in the Winelands and greater Cape Town area. He is part of the Skinmatters Mohs and Reconstructive Unit.