Evaluation and Management of Hypertension in the Perioperative Period of Mohs Micrographic Surgery: A Review

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Abstract

BACKGROUND

While patients’ hypertensive problems are usually actively and effectively managed by their primary physician, the dermatologic surgeon can still be affected by hypertension where the condition is unrecognized or uncontrolled. Hypertension is an important contributor to both bleeding and hematoma formation during and after surgery, ultimately affecting functional and cosmetic outcomes.

OBJECTIVE

To extensively review the literature on perioperative management of the hypertensive patient as relates to the dermatologic surgeon.

MATERIALS AND METHODS

An updated and comprehensive literature review, focusing on current diagnostic guidelines, practice by specific dermatologic surgery groups and management recommendations, was conducted.

RESULTS

Review of the literature does support generalized guidelines for the management of hypertensive patients in the Mohs Micrographic Surgery (MMS) setting; however data on implementation and outcomes by specific dermatologic surgery groups is variable and lacking.

CONCLUSIONS

The treatment of nonmelanoma skin cancers with MMS is now routine, and fortunately can be performed quite safely. There are still improvements to be made however, in managing perioperative hypertension—both in making patients aware of their condition and in treating it effectively. Practicing these measures can promote patients’ overall health and the efficiency of the dermatologic surgeon’s practice.

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