Tumor Debulking in Mohs Surgery

Dear study participant,

Dr. Thomas Hocker and colleagues from the University of Kansas Medical Center (KUMC) are conducting a research study. We are contacting you because you are a Mohs surgeon associated with ACMS. We are recruiting participants to help us determine the debulking strategy used by most dermatologists during Mohs surgery. Participation involves completing a survey that will take about 5 minutes. No identifiable information will be collected about you, and the survey is anonymous. In addition to the survey questions, we will request your age, gender, and practice details.

There are no personal benefits or risks to participating in this study. Participation is voluntary, and you can stop taking the survey at any time.

If you have any questions, please contact Brett Neill at bneill@kumc.edu. For questions about the rights of research participants, you may contact the KUMC Institutional Review Board (IRB) at (913) 588-1240 or humansubjects@kumc.edu

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* 1. What is your age in years?

25-32

33-40

41-48

49-56

57-64

65 or greater

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* 2. What is your gender?

Male

Female

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* 3. How many years have you been practicing Mohs Surgery?

0-9 Years

10-19 years

20 years or more

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* 4. What region of the country are you in?

Midwest - IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI

Northeast - CT, DC, DE, MA, MD, ME, NH, NJ, NY, PA, RI, VT

Southeast - AL, AR, FL, GA, KY, LA, MS, NC, SC, TN, VA, WV

Southwest - AZ, NM, OK, TX

West - AK, CA, CO, HI, ID, MT, NV, OR, UT, WA, WY

Location outside of the USA (please specify country)

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* 5. What is your practice setting?

Private - Solo

Private - Group

Hospital - Teaching

Hospital - Non Teaching

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* 6. How frequently do you use tumor debulking prior to excision when performing Mohs surgery?

0% of cases (Never)

100% of cases (Always)

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 7. If/when you choose to debulk the tumor, what technique do you prefer to use the majority of the time?

Debulking with curette

Debulking with scalpel (sharp debulking)

I use techniques A and B above equally

I do NOT perform tumor debulking

Other (please specify)

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* 8. For each anatomic location, which form of debulking do you prefer

	Sharp Debulking	Curettage Debulking	Neither
Scalp	Scalp Sharp Debulking	Scalp Curettage Debulking	Scalp Neither
Eyelid	Eyelid Sharp Debulking	Eyelid Curettage Debulking	Eyelid Neither
Ear	Ear Sharp Debulking	Ear Curettage Debulking	Ear Neither
Cheek	Cheek Sharp Debulking	Cheek Curettage Debulking	Cheek Neither
Nose	Nose Sharp Debulking	Nose Curettage Debulking	Nose Neither
Mucosal Lip	Mucosal Lip Sharp Debulking	Mucosal Lip Curettage Debulking	Mucosal Lip Neither
Arm	Arm Sharp Debulking	Arm Curettage Debulking	Arm Neither
Dorsal Hand	Dorsal Hand Sharp Debulking	Dorsal Hand Curettage Debulking	Dorsal Hand Neither
Penis	Penis Sharp Debulking	Penis Curettage Debulking	Penis Neither
Shin	Shin Sharp Debulking	Shin Curettage Debulking	Shin Neither

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* 9. In your opinion for each variable, would you say that sharp debulking or curettage debulking is superior

	Sharp debulking (strongly superior)	Sharp debulking (somewhat superior)	Neutral (both are similarly effective)	Curettage (somewhat superior)	Curettage (strongly superior)
Margin Size	Margin Size Sharp debulking (strongly superior)	Margin Size Sharp debulking (somewhat superior)	Margin Size Neutral (both are similarly effective)	Margin Size Curettage (somewhat superior)	Margin Size Curettage (strongly superior)
Larger lesions	Larger lesions Sharp debulking (strongly superior)	Larger lesions Sharp debulking (somewhat superior)	Larger lesions Neutral (both are similarly effective)	Larger lesions Curettage (somewhat superior)	Larger lesions Curettage (strongly superior)
Ability to perform single section mohs	Ability to perform single section mohs Sharp debulking (strongly superior)	Ability to perform single section mohs Sharp debulking (somewhat superior)	Ability to perform single section mohs Neutral (both are similarly effective)	Ability to perform single section mohs Curettage (somewhat superior)	Ability to perform single section mohs Curettage (strongly superior)
Ease of grossing fresh tissue specimen	Ease of grossing fresh tissue specimen Sharp debulking (strongly superior)	Ease of grossing fresh tissue specimen Sharp debulking (somewhat superior)	Ease of grossing fresh tissue specimen Neutral (both are similarly effective)	Ease of grossing fresh tissue specimen Curettage (somewhat superior)	Ease of grossing fresh tissue specimen Curettage (strongly superior)
Ability to identify gross extent of tumor	Ability to identify gross extent of tumor Sharp debulking (strongly superior)	Ability to identify gross extent of tumor Sharp debulking (somewhat superior)	Ability to identify gross extent of tumor Neutral (both are similarly effective)	Ability to identify gross extent of tumor Curettage (somewhat superior)	Ability to identify gross extent of tumor Curettage (strongly superior)
Lower risk of avulsing adjacent normal tissue	Lower risk of avulsing adjacent normal tissue Sharp debulking (strongly superior)	Lower risk of avulsing adjacent normal tissue Sharp debulking (somewhat superior)	Lower risk of avulsing adjacent normal tissue Neutral (both are similarly effective)	Lower risk of avulsing adjacent normal tissue Curettage (somewhat superior)	Lower risk of avulsing adjacent normal tissue Curettage (strongly superior)
Lower risk of pushing tumor down deeper in tissue	Lower risk of pushing tumor down deeper in tissue Sharp debulking (strongly superior)	Lower risk of pushing tumor down deeper in tissue Sharp debulking (somewhat superior)	Lower risk of pushing tumor down deeper in tissue Neutral (both are similarly effective)	Lower risk of pushing tumor down deeper in tissue Curettage (somewhat superior)	Lower risk of pushing tumor down deeper in tissue Curettage (strongly superior)
Total debulking time	Total debulking time Sharp debulking (strongly superior)	Total debulking time Sharp debulking (somewhat superior)	Total debulking time Neutral (both are similarly effective)	Total debulking time Curettage (somewhat superior)	Total debulking time Curettage (strongly superior)
Total surgical time	Total surgical time Sharp debulking (strongly superior)	Total surgical time Sharp debulking (somewhat superior)	Total surgical time Neutral (both are similarly effective)	Total surgical time Curettage (somewhat superior)	Total surgical time Curettage (strongly superior)
Average number of Mohs layers	Average number of Mohs layers Sharp debulking (strongly superior)	Average number of Mohs layers Sharp debulking (somewhat superior)	Average number of Mohs layers Neutral (both are similarly effective)	Average number of Mohs layers Curettage (somewhat superior)	Average number of Mohs layers Curettage (strongly superior)
Histotechnician time	Histotechnician time Sharp debulking (strongly superior)	Histotechnician time Sharp debulking (somewhat superior)	Histotechnician time Neutral (both are similarly effective)	Histotechnician time Curettage (somewhat superior)	Histotechnician time Curettage (strongly superior)

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* 10. What factors determine if you debulk a tumor? (select all that apply)

Size of the lesion

Location of the lesion

Type of Malignancy

Past medical history of patient

I debulk in every case irrespective of outside factors

I never debulk

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* 11. According to the most recent "improving wisely" report, what is your average number of layers taken per case in Mohs surgery (select closest value)

<1.3

1.31-1.4

1.41-1.5

1.51-1.6

1.61-1.7

1.71-1.8

1.81-1.9

1.91-2.0

2.01-2.1

2.11-2.2

2.21-2.3

2.31-2.4

>2.41

I prefer not to answer

Unsure

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* 12. What does your practice utilize?

Single Section Mohs utilizing a 45 degree bevel

Single Section Mohs utilizing a 90 degree bevel (no bevel)

Multi Section Mohs utilizing a 45 degree bevel

Multi Section Mohs utilizing a 90 degree bevel (no bevel)

Tumor Debulking in Mohs Surgery

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* 1. What is your age in years?

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* 2. What is your gender?

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* 3. How many years have you been practicing Mohs Surgery?

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* 4. What region of the country are you in?

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* 5. What is your practice setting?

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* 6. How frequently do you use tumor debulking prior to excision when performing Mohs surgery?

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* 7. If/when you choose to debulk the tumor, what technique do you prefer to use the majority of the time?

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* 8. For each anatomic location, which form of debulking do you prefer

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* 9. In your opinion for each variable, would you say that sharp debulking or curettage debulking is superior

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* 10. What factors determine if you debulk a tumor? (s﻿elect all that apply)

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* 11. According to the most recent "improving wisely" report, what is your average number of layers taken per case in Mohs surgery (select closest value)

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* 12. What does your practice utilize?

* 10. What factors determine if you debulk a tumor? (select all that apply)