Avoiding Electrocautery: Hemostatic Agents for Perioperative Bleeding in Mohs Micrographic Surgery

Document Type

Article

Publication Date

9-5-2025

Publication Title

Dermatologic Surgery

Abstract

BACKGROUND Bleeding remains a frequent complication during Mohs micrographic surgery, particularly among patients receiving anticoagulant or antiplatelet therapy. The growing use of these medications has prompted increased exploration of adjunctive methods to improve perioperative hemostasis. OBJECTIVE To systematically review the literature on topically and locally administered hemostatic agents used to reduce bleeding in Mohs micrographic surgery. METHODS A systematic search of PubMed, Scopus, Cochrane, and EMBASE was conducted through March 2024. Original studies evaluating hemostatic agents applied topically or by local injection during Mohs micrographic surgery were included. RESULTS Seven studies met inclusion criteria, encompassing 458 patients. Agents evaluated included tranexamic acid, brimonidine gel, hemostatic powders, and microporous polysaccharide materials. These agents were generally well tolerated and associated with reductions in intraoperative and postoperative bleeding. CONCLUSION Locally administered hemostatic agents offer a promising adjunct to improve bleeding control in Mohs micrographic surgery. Their use may be particularly beneficial in patients at elevated bleeding risk and warrants further investigation in larger, controlled studies.

PubMed ID

40910604

Publisher

Wolters Kluwer Health

Rights

© 2025 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved, including those for text and data mining, AI training, and similar technologies. | Content use for text and data mining and artificial intelligence training is not permitted.

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