Factors affecting choice of repair in Mohs micrographic surgery for non‐melanoma skin cancer of the head

Thomas, Charlotte L; Lam, A; Lam, Janice; Paver, Robert; Storey, Leslie; Fernández‐Peñas, Pablo

doi:10.1111/ajd.12453

Cited by 9 publications

(6 citation statements)

References 19 publications

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“…However, our result is consistent with the general trend in the U.S. of increasing number of older white men who develop skin cancer. 4 Similar to the study of Thomas et al, 5 in which the average defect size was 1.72 cm 2 , the average defect size in this study measures 3.09 cm 2 . The majority of our defects occurred on the nose (24.3%), especially the nasal ala (35.6%) and the nasal tip (24.0%).…”

Section: Discussionsupporting

confidence: 78%

Patient, Defect, and Surgical Factors Influencing Use of Ancillary Procedures after Facial Mohs Repairs

et al. 2021

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This article determines if patient, defect, and repair factors can be used to predict the use of additional treatments to achieve optimal aesthetic results after repair of facial Mohs defects. An electronic chart review of patients undergoing Mohs excision and reconstruction of facial neoplasms from November 2005 to April 2017 was performed, reviewing patient demographics and history, tumor size, defect size and location, method and service of reconstruction, time between resection and repair, complications, and subsequent treatments. A total of 1,500 cases with basal cell and squamous cell carcinoma were analyzed. The average defect size was 3.09 ± 8.06 cm2; 81.9% of defects were less than 4 cm2 in size. Advancement flaps were used to repair 44.3% of defects. Complications and undesired sequelae (CUS) were noted in 15.9% of cases; scar hypertrophy or keloid (10.8%) was most common. Postoperative ancillary procedures were performed in less than one-quarter (23.4%) of patients to enhance the postrepair appearance; the most common procedures were intralesional corticosteroid injections and pulse dye laser treatments. CUS were more likely in females (19.6%), defects on the lips (28.7%) and on the nose (27.3%) (p < 0.001 for each). Females (22.7% vs. 12.7%), lip repairs (40.2% vs. 18.3%), transposition flaps (39.2% vs. 14.8%), and repairs performed by a dermatologist (17.9% vs. 11.2%) (p < 0.001 for each) were more likely to be treated with postoperative corticosteroid injections. Females (14.5% vs. 7.4%), patients under the age of 60 years (13.9% vs. 8.8%), and patients whose repair was performed by a dermatologist (11.9% vs. 2.9%) (p < 0.001 for each) were more likely to receive postoperative pulsed dye laser treatments. CUS and ancillary procedures after repair of facial Mohs defects are uncommon. Awareness of individual risk factors and defect characteristics allows the surgeon to choose the most appropriate repair technique while anticipating the potential need for ancillary procedures.

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Section: Discussionsupporting

confidence: 78%

Patient, Defect, and Surgical Factors Influencing Use of Ancillary Procedures after Facial Mohs Repairs

et al. 2021

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“…MMS allows for the complete removal of cancer while minimizing the loss of normal tissue surrounding the tumor in aesthetically sensitive regions such as the face [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most common application of MMS is the treatment of non-melanoma skin cancers. Particularly, randomized controlled trials conducted based on patients who had undergone basal cell carcinoma excision with MMS in the previous 10 years have reported a 4% recurrence [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of Large Facial Defects via Excision of Skin Cancer Using Two or More Regional Flaps

et al. 2017

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BackgroundFree-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. MethodsAmong patients undergoing MMS for skin cancer at Pusan National University Hospital between January 2013 and December 2015, we evaluated 7 patients (2 males, 5 females; average age, 73.14 years) treated for large facial defects from basal cell carcinoma. Based on operative and follow-up records, we investigated the number and type of flaps used, postsurgical complications, and patients’ post-surgical satisfaction. ResultsTwo and 3 types of flaps were used for 5 and 2 patients, respectively. Most frequently used were nasolabial flaps (7 times in 6 patients) and forehead flaps (once in each of 4 patients). The average follow-up period was 14 months, with no complications—including necrosis, hematoma, or wound dehiscence—observed. Post-surgical satisfaction averaged 4.4 out of a maximum of 5 points. ConclusionsReconstruction using two or more flaps for large facial defects after skin cancer removal using MMS produced satisfactory outcomes while preventing aesthetic problems. Practitioners should consider using multiple flaps when choosing a reconstruction method for large facial defects following skin cancer removal.

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“…With the advancement in 3D technology, a fast, for every} reconstruction technique in each cosmetic fractional monetary unit. [4,5,6]…”

Section: Computerised 3d Rhetorical Facialmentioning

confidence: 99%

Facial Reconstruction and Cosmetology - A Review

Monisha B. M,

Abirami Arthanari,

Pushpalatha

et al. 2021

MLU

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Facial reconstruction can be used to identify unknown human skeletal remains when other techniques be unsuccessful. Through this review, we try to assessment the different methods of facial reconstruction stated in literature. There are several techniques of doing facial reconstruction, which vary from two dimensional drawings to three-dimensional clay models. With the advancement in 3D technology, a rapid, efficient and cost-effective computerized 3D reconstruction method has been developed which has brought down the grade of mistake before come across. Recognition allows the involved administration activities to make a list of assumed victims. This list can then be pointed down and a positive identification may be given by the more conventional method of forensic field. Facial reconstruction allows visual identification by the individual's family and associates to become easy and more definite. And here cosmetic reconstruction also plays a best role in investigating the criminals and legal part.

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Factors affecting choice of repair in Mohs micrographic surgery for non‐melanoma skin cancer of the head

Cited by 9 publications

References 19 publications

Patient, Defect, and Surgical Factors Influencing Use of Ancillary Procedures after Facial Mohs Repairs

Patient, Defect, and Surgical Factors Influencing Use of Ancillary Procedures after Facial Mohs Repairs

Reconstruction of Large Facial Defects via Excision of Skin Cancer Using Two or More Regional Flaps

Facial Reconstruction and Cosmetology - A Review

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