Facial Reconstruction following Mohs Micrographic Surgery: A Report of 622 Cases

Grosfeld, Eline C.; Smit, Jeroen M.; Krekels, Gertruud A. M.; Rappard, Julien H. A. van; Hoogbergen, Maarten M.

doi:10.2310/7750.2013.13188

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…In the SCC group, the predominant types of closures were linear closure and flaps. We have found that the use of grafts and second intention techniques is more common in the SCC group, which is consistent with some studies that found that the techniques of closure most often used for reconstructing MMS defects are linear closures and flaps . However, these studies do not distinguish between BCC and SCC reconstruction.…”

Section: Discussionsupporting

confidence: 90%

“…We have found that the use of grafts and second intention techniques is more common in the SCC group, which is consistent with some studies that found that the techniques of closure most often used for reconstructing MMS defects are linear closures 32 and flaps. 1,33 However, these studies do not distinguish between BCC and SCC reconstruction. The more common use of grafts, linear closures, and second intention in the SCC group may be intuitively explained by the potentially more aggressive behavior of these tumors, which prevents the surgeon from performing complex reconstructions that could bury a future recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

et al. 2018

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Background The two main tumors treated with Mohs micrographic surgery (MMS) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). There are no studies analyzing whether MMS is different when treating these two types of tumors. Objective We aim to compare the characteristics of the patients, the tumors, and MMS, and first‐year follow‐up of MMS in BCC and SCC. Methods REGESMOHS is a prospective cohort study of patients treated with MMS. The participating centers are 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patients, tumors, and surgery were recorded. The follow‐up was done with two visits: the first visit within 1 month after surgery and the second one within the first year. Results From July 2013 to April 2017, a total of 2,669 patients who underwent MMS were included in the registry. Of them, 2,448 (93%) were diagnosed with BCC, and 181 (7%) were diagnosed with SCC. Patients with SCC were older than those with BCC (median age 73 years vs. 68 years) and presented immunosuppression more frequently. The tumor size was significantly larger in the SCC group. Regarding surgery, deeper invasion was more frequent in SCC, resulting in larger defects. Despite this, SCC did not require more stages to get clear margins or more time in the operating room. Incomplete Mohs was more frequent in the SCC group (6%) than in the BCC group (2%). The incidence of perioperative complications was higher when treating SCC. There were more relapses in the first‐year follow‐up in the SCC group. Conclusion There are significant differences when comparing MMS in BCC and SCC. Knowledge of these differences can help to prepare the patient and plan the surgery, optimizing results.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

et al. 2018

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“…Grandes series muestran una predominancia de mujeres entre los pacientes, mientras que en nuestro estudio se vio mayor frecuencia en hombres (7)(8)(9) . Leibovitch y colaboradores y Ruiz-Salas y colaboradores reportaron un leve predominio de pacientes hombres (10,11) .…”

Section: Discussionunclassified

“…La frecuencia de métodos reconstructivos descrita para nuestros pacientes se asemeja a lo descrito en estudios más grandes, en donde los colgajos (como grupo) son de preferencia (7,9,19) . Hussain y colaboradores reportan una incidencia de complicaciones menores de 7,78% en sus CMM, las cuales fueron de características similares a las vistas en nuestros pacientes (15) .…”

Section: Tamaño De Los Defectos Quirúrgicos Finalesunclassified

Cirugía micrográfica de Mohs en Uruguay: primeros 130 casos en carcinomas cutáneos

Magliano

Navarrete

Martı́nez

et al. 2018

RMU

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ResumenIntroducción: la cirugía micrográfica de Mohs es una técnica para la exéresis de cánceres de piel con el examen histológico del 100% de los márgenes quirúrgicos, logrando la tasa de curación más alta con máxima preservación de tejido sano.Objetivo: realizar una descripción clínico-epidemiológica de nuestras primeras 130 cirugías en el Hospital de Clínicas. Método: análisis descriptivo de todos los pacientes operados por un único cirujano de Mohs en nuestra Unidad de CirugíaDermatológica desde noviembre de 2013 hasta junio de 2016. Se registraron datos clínicos, tumorales y quirúrgicos.Resultados: se estudiaron 130 cirugías en 90 pacientes; 62,3% fueron realizadas en hombres y 37,7% en mujeres. La edad media fue de 68 años (rango: 33-90 años). El 67,7% provenía de Montevideo y el 32,3% del interior del país. El 68% correspondía a carcinoma basocelular y 32% a carcinoma espinocelular. El 91,5% eran tumores primarios y el 8,5% recurrentes. El 75,3% se encontraba en cabeza y cuello. El tipo más frecuente de cierre fueron los colgajos en 43% (56). Hasta el momento, 70 pacientes han completado seguimiento de al menos un año, donde se vio recidiva tumoral en un solo caso (1/70; 1,43%).Conclusiones: la cirugía de Mohs es un procedimiento seguro y eficaz, y nuestros resultados coinciden con lo descrito en centros de referencia internacional. Este es el primer centro de Uruguay que cuenta con un cirujano de Mohs y presentamos el primer estudio en pacientes uruguayos.

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“… 6 Choice will depend on the type and size of the defect, patient’s characteristics as well as surgeon’s skills and preferences. 7 …”

Section: Introductionmentioning

confidence: 99%

Keep it simple. A ten-year experience in reconstructions after Mohs micrographic surgery

Brandão

Weimann

Terzian

et al. 2020

Anais Brasileiros de Dermatologia

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Background Mohs micrographic surgery is worldwide used for treating skin cancers. After obtaining tumor-free margins, choosing the most appropriate type of closure can be challenging. Objectives Our aim was to associate type of surgical reconstructions after Mohs micrographic surgery with the characteristics of the tumors as histological subtype, anatomical localization and especially number of surgical stages to achieve complete excision of the tumour. Methods Transversal, retrospective analyses of medical records. Compilation of data such as gender, age, tumor location, histological subtype, number of stages to achieve clear margins and type of repair used. Results A total of 975 of facial and extra-facial cases were analyzed. Linear closure was the most common repair by far (39%) and was associated with the smallest number of Mohs micrographic surgery stages. This type of closure was also more common in most histological subtypes and anatomical locations studied. Using Poisson regression model, nose defects presented 39% higher frequency of other closure types than the frequency of primary repairs, when compared to defects in other anatomic sites ( p < 0.05). Tumors with two or more stages had a 28.6% higher frequency of other closure types than those operated in a single stage ( p < 0.05). Study limitations Retrospective study with limitations in obtaining information from medical records. The choice of closure type can be a personal choice. Conclusions Primary closure should not be forgotten especially in surgical defects with fewer stages and in non-aggressive histological subtypes in main anatomic sites where Mohs micrographic surgery is performed.

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Facial Reconstruction following Mohs Micrographic Surgery: A Report of 622 Cases

Abstract: Facial reconstruction following Mohs micrographic surgery is challenging. The type of reconstruction used depends on the type of defect and patient characteristics. A structured multidisciplinary approach improves the process from defect to reconstruction and can facilitate referrals.

Cited by 11 publications

References 10 publications

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

Cirugía micrográfica de Mohs en Uruguay: primeros 130 casos en carcinomas cutáneos

Keep it simple. A ten-year experience in reconstructions after Mohs micrographic surgery

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