Broader Practice Indications for Mohs Surgical Defect Healing by Secondary Intention: A Survey Study

Vedvyas, Chetan; Cummings, Patricia L.; Geronemus, Roy G.; Brauer, Jeremy A.

doi:10.1097/dss.0000000000000998

Cited by 11 publications

(18 citation statements)

References 18 publications

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“…A survey study found that the most experienced surgeons were significantly more likely to heal deep and larger wounds secondarily. 8 The use of SIH as a reconstructive option remains very physician and institution dependent as evidenced by a systematic review 1 where SIH was part of a reconstructive ladder, but SIH was not listed as surgical option in a 105 patient, single institution study. 9 SIH over areas of absent periosteum has been previously documented.…”

Section: Discussionmentioning

confidence: 99%

Secondary Intention Healing Over Exposed Bone on the Scalp, Forehead, and Temple Following Mohs Micrographic Surgery

Wong

Zloty

2022

J Cutan Med Surg

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Background Removal of skin cancers on the scalp, forehead, and temple can result in surgical defects with exposed bone. In such cases, reconstruction becomes challenging due to limited vascularity for flap or graft repair. Objective Demonstrate the usefulness of secondary intention healing of scalp, forehead, and temple defects over exposed bone. Methods/Materials A retrospective case series of 41 patients who had Mohs Micrographic Surgery with post-surgical scalp, forehead, or temple defects involving exposed bone. These patients then underwent secondary intention healing. Results 90% of patients successfully healed. Average time to complete granulation was 92 days, and average time to full re-epithelialization was 186 days. Visual analog scale assessment of final scar quality resulted in 57% being good, 35% being fair, and 8% being poor. No patient had infection or other serious complication. Mean follow-up duration was 272 days. Conclusion This case series shows the viability of secondary intention healing of scalp wounds over exposed bone. Study power was not adequate to predict time to complete healing based on defect size, or allow association of patient factors with the risk of nonhealing. Managing patient expectations, and emphasizing the importance of early occlusive wound care is paramount for healing success.

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Section: Discussionmentioning

confidence: 99%

Secondary Intention Healing Over Exposed Bone on the Scalp, Forehead, and Temple Following Mohs Micrographic Surgery

Wong

Zloty

2022

J Cutan Med Surg

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“…: medial canthus (9), lateral canthus (3), lower eyelid (1). b Among lip subunits: cutaneous lip (4), vermillion lip(8).…”

mentioning

confidence: 99%

Second-Intention Healing in Mohs Micrographic Surgery: A Single-Center Academic Experience

Barrera-Llaurador

Carrasquillo²,

Santiago-Vázquez³

et al. 2022

Adv Skin Wound Care

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OBJECTIVE To describe the trends in second-intention healing (SIH) use at a single Mohs micrographic surgery (MMS) dermatology clinic and assess outcomes and patient satisfaction. METHODS The authors conducted a single-center, retrospective study of patients who underwent MMS from November 2012 through November 2018. Data obtained for each patient included sex, age, tumor characteristics, number of MMS stages, final defect size, and postoperative complications. Patient satisfaction of SIH was retrospectively assessed by telephone survey. RESULTS Providers used SIH in 22% of all MMS cases (n = 159/718). It was most commonly used for defects located on the nose, ear, temple, and periocular region. The average defect size and number of MMS stages for tumor clearance were 1.3 cm and 1.5 stages, respectively. Overall, low rates of postoperative complications were observed, and 95% of patients reported optimal or acceptable levels of satisfaction. CONCLUSIONS This study supports the idea that SIH is a safe, effective alternative for wound management and may have broader practice indications than those traditionally proposed.

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“…These three cases demonstrate the effective use of SG to facilitate SI healing of scalp and limb surgical defects. SI healing may be preferable for scalp defects with exposed periosteum and when defects cannot be closed with sutures. There is a shorter surgical time and lower risk of damage to neighbouring structures, and the technique facilitates close surveillance .…”

mentioning

confidence: 99%

“…SI healing may be preferable for scalp defects with exposed periosteum and when defects cannot be closed with sutures. There is a shorter surgical time and lower risk of damage to neighbouring structures, and the technique facilitates close surveillance . The primary disadvantage is prolonged wound care .…”

mentioning

confidence: 99%

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Use of silicone gel to enhance skin wound healing by secondary intention following tumour excision on the scalp and extremities

Yong

Goh

2018

Clin Exp Dermatol

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Broader Practice Indications for Mohs Surgical Defect Healing by Secondary Intention: A Survey Study

Cited by 11 publications

References 18 publications

Secondary Intention Healing Over Exposed Bone on the Scalp, Forehead, and Temple Following Mohs Micrographic Surgery

Secondary Intention Healing Over Exposed Bone on the Scalp, Forehead, and Temple Following Mohs Micrographic Surgery

Second-Intention Healing in Mohs Micrographic Surgery: A Single-Center Academic Experience

Use of silicone gel to enhance skin wound healing by secondary intention following tumour excision on the scalp and extremities

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