Sheffield 2026 Presented e-posters Thursday

To evaluate our novel Integrated Practice Unit (IPU) approach to peri-ocular skin cancer management in which both Mohs Micrographic Surgery (MMS) and oculoplastic reconstruction services are combined at the Dermatology Skin Cancer Unit at Guy’s Hospital.We aimed to audit the service using established standards including BOPSS/BAPRAS MMS UK surgical standards & service guidance.

A 3-year retrospective audit of the IPU was performed between October 2023 and September 2025, Data were collected from the hospital electronic patient records system, EPIC.

A total of 168 patients were managed over 3 years by one oculoplastic surgeon, and the average number of patients treated per list was 3. 60% were female, with a mean age of 67 years and a range of 22- 94. Most patients were referred to the service by consultants (57%, 96/168) and from a wide geographical area. GP referrals made up 42% (71/168). Basal cell carcinoma was the most common diagnosis (92%, 154/168) while squamous cell carcinoma was diagnosed in 8% (13/168). Medial canthal involvement was present in 46% (77/168)
Mohs levels for clearance ranged from 1-3 with a mean of 1.7 levels. Average defect size was 306mm2 (17.5 x17.5mm) with a maximum defect size of 3150mm2. A full thickness skin graft was used for reconstruction in 37% of cases (62/168). All patients were reviewed in a dedicated post-operative clinic at 2-3 weeks. Post-operative lagophthalmos was found in 1.2% (2/168), ectropion (including watery eye) in 1.2%, and possible pre-septal cellulitis treated by the GP in 0.6% (1/168). 5 of 168 required further surgery for scar revision or lid repositioning.

The Integrated Practice Unit approach represents a safe, efficient, and sustainable model for peri-ocular skin cancer management.
This COVID-19 legacy pathway reduces delays and hospital visits without compromising clinical outcomes, supporting its continued use and potential wider adoption in oculoplastic and skin cancer services.