Exploring Environmental Sustainability in Mohs Micrographic Surgery

BACKGROUND Health care resource use, pollution, and greenhouse gas emissions are increasingly studied to balance quality patient care with environmental, social, and financial impacts. However, consolidated sustainability recommendations for Mohs micrographic surgery (MMS) remain unexplored. OBJECTIVE To assess current recommendations and studies on environmental sustainability in MMS. MATERIALS AND METHODS Following PRISMA-ScR guidelines, a literature review was conducted across PubMed, ScienceDirect, Scopus, Web of Science, and Cochrane databases from 2014 to 2024. English peer-reviewed studies using keywords “climate change,” “margin control,” “environment,” “sustainability,” “waste,” “resource,” “Mohs micrographic,” “Mohs,” and “micrographic” were included. Duplicates and conference abstracts were excluded. RESULTS Of 5,526 articles, nine met inclusion criteria after independent review. Recommendations included standardized surgical sets, limiting instruments to essentials, and redesigning procedure rooms to improve recycling access. Three articles found no significant difference in infection rates between sterile and nonsterile glove use. Other suggestions involved recycling plastics, using microtubules to reduce chromacoding dye waste by minimizing spillage and drying, and scheduling virtual preoperative visits to reduce travel emissions. Insurance reimbursement for virtual visits remains a limitation. CONCLUSION Restructuring surgical protocols and procedure room design encourages innovation and addresses workflow inefficiencies rooted in tradition rather than evidence, promoting sustainability in MMS.