Review and reappraisal of assessment parameters of second intention healing after Mohs micrographic surgery

Schwartzman, Gabrielle; Cartron, Alexander M; Khachemoune, Amor

doi:10.1007/s00403-021-02209-y

Cited by 6 publications

(8 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, it was also reassuring that no adverse events (AEs) were recorded in patients whose wounds were allowed to heal by SIH (Supplementary Table S2), supporting several studies that have shown that SIH can provide excellent cosmetic results. 10,11 Although SIH is not suitable for every wound defect, generally being reserved for concave anatomical locations, 12 these results should encourage general dermatologists performing skin surgery that SIH should not be overlooked for wound reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of wound complications following Mohs micrographic surgery (MMS): a cross-sectional study of 1000 patients undergoing MMS and wound repair in a UK teaching hospital

Rutkowski

Littlewood²,

Touyz³

et al. 2022

Clinical and Experimental Dermatology

View full text Add to dashboard Cite

Background Mohs micrographic surgery (MMS) for nonmelanoma skin cancer is often quoted as having an excellent safety profile. Aim To determine the complication rate of patients undergoing MMS in a large UK Mohs unit and subdivide complication rates into mild/intermediate and major, and to identify potential risk factors necessitating a clinical intervention. Methods This was a single‐centre, cross‐sectional study of 1000 consecutive cases of MMS performed with in‐house repair. Notes from the postsurgical dressing clinics were reviewed at Visit 1 (Days 7–14) and Visit 2 (approximately Week 6). Based upon the intervention required and effect on cosmetic/functional outcome, complications were classified as minor, intermediate or major. Logistic regression modelling was used to identify risk factors associated with a complication that needed a clinical intervention (i.e. intermediate or major). Results In total, 1000 Mohs surgeries were performed on 803 patients, resulting in 1067 excisions. Complication rates in our cohort were low (minor 3.6%, intermediate 3.1% and major 0.8%) Potential risk factors for developing a complication included skin graft (unadjusted OR = 4.89, 95% CI 1.93–12.39; fully adjusted OR = 7.13, 95% CI 2.26–22.45) and patients undergoing surgery on the forehead (unadjusted OR = 3.32, 95% CI 0.95–11.58; fully adjusted OR = 5.34, 95% CI 1.40–20.42). Patients whose wounds were allowed to heal by secondary intention healing (6.8%) exhibited no complications. Conclusion We advocate that patients should be informed during the consent procedure that less than 1 in every 100 patients (0.75%) undergoing MMS will have a serious adverse event (major complication) affecting their cosmetic or functional outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of wound complications following Mohs micrographic surgery (MMS): a cross-sectional study of 1000 patients undergoing MMS and wound repair in a UK teaching hospital

Rutkowski

Littlewood²,

Touyz³

et al. 2022

Clinical and Experimental Dermatology

View full text Add to dashboard Cite

show abstract

“…Secondary wound healing allows for defect healing after surgical removal of malignant or benign skin lesions in skin surgery and may be used as an alternative to other wound closure techniques in suitable cases. [38][39][40][41] A survey among members of the American College of Mohs Surgery conducted in 2015 showed that secondary wound healing following microscopically controlled skin surgery is widely used with good results. 38 Both superficial wound defects and deep wounds after skin surgery are left open for secondary wound healing.…”

Section: Secondary Wound Healingmentioning

confidence: 99%

“…[38][39][40][41] A survey among members of the American College of Mohs Surgery conducted in 2015 showed that secondary wound healing following microscopically controlled skin surgery is widely used with good results. 38 Both superficial wound defects and deep wounds after skin surgery are left open for secondary wound healing. This procedure is primarily used for relatively small wound defects (< 2 cm) on concave localizations (temple, inner canthus, nasolabial area).…”

Section: Secondary Wound Healingmentioning

confidence: 99%

Perioperative antibiotic prophylaxis in skin surgery – Position paper of the Antibiotic Stewardship working group of the German Society for Dermatologic Surgery (DGDC), Part 2: Special indications and situations

Balakirski,

Becker,

Hartmann

et al. 2023

J Deutsche Derma Gesell

View full text Add to dashboard Cite

SummaryIn addition to prevention of surgical site infections after skin surgery, perioperative antibiotic prophylaxis (PAP) aims to prevent the occurrence of other postoperative infectious complications, especially bacterial endocarditis and hematogenous joint prosthesis infections. This article discusses specific indications for the use of PAP. For example, patients who have undergone any type of heart valve replacement, including transcatheter valve replacement or use of prosthetic material to correct the heart valve, or patients who have experienced bacterial endocarditis, require PAP during skin surgery on mucosal membranes or ulcerated tumors.The use of PAP in special situations such as secondary wound healing, septic dermatosurgery or ulcer surgery is also presented and discussed in detail in this paper based on the current scientific literature. This paper represents the second part of the position paper of the Antibiotic Stewardship Working Group of the German Society for Dermatologic Surgery (DGDC) and summarizes evidence‐based recommendations for the administration of PAP during skin surgery for special indications and situations. This is particularly important because, as detailed in Part 1 of this position paper, PAP can and usually should be avoided in skin surgery.

show abstract

“… 12 , 13 Medically fragile patients or those who are ineligible for incisional repair may be limited to second intention healing, a method typically reserved for smaller concave surfaces. 14 …”

Section: Introductionmentioning

confidence: 99%

Mohs Defect Repair with Dehydrated Human Amnion/Chorion Membrane

Toman

Michael²,

Wisco

et al. 2022

Facial Plastic Surgery & Aesthetic Medicine

View full text Add to dashboard Cite

Importance: Reconstructing cosmetically sensitive defects in an aging population undergoing multiple Mohs micrographic surgeries (MMS) may be addressed with alternatives to surgery. Objective: Patients undergoing MMS with defect reconstruction in visually prominent areas receiving placental allograft were compared with traditional autologous tissue-based procedures—flaps and full-thickness skin grafts (FTSG). Design, Setting, and Participants: This retrospective case–control study evaluated patients who underwent MMS for removal of a basal or squamous cell carcinoma with same-day repair. Main Outcomes and Measures: The primary endpoint was the incidence and comparison of postoperative morbidity. Risk for developing medical or cosmetic sequelae was determined through multivariate logistic regression. Results: The study population consisted of 143 propensity score-matched pairs ( n = 286) with moderate- to high-risk defects on the face, head, and neck. Compared with autologous tissue, placental allograft cases were associated with significantly lower risk for infection ( p = 0.004), poor scar cosmesis ( p < 0.0001), scar revision ( p < 0.0001), or reoperation ( p = 0.0007). Conclusions and Relevance: Postoperative complication rates for placental reconstructions did not exceed those demonstrated by autologous tissue counterparts, indicating this is a safe alternative to flap and FTSG in cosmetically sensitive repairs.

show abstract

Review and reappraisal of assessment parameters of second intention healing after Mohs micrographic surgery

Cited by 6 publications

References 39 publications

Prevalence of wound complications following Mohs micrographic surgery (MMS): a cross-sectional study of 1000 patients undergoing MMS and wound repair in a UK teaching hospital

Prevalence of wound complications following Mohs micrographic surgery (MMS): a cross-sectional study of 1000 patients undergoing MMS and wound repair in a UK teaching hospital

Perioperative antibiotic prophylaxis in skin surgery – Position paper of the Antibiotic Stewardship working group of the German Society for Dermatologic Surgery (DGDC), Part 2: Special indications and situations

Mohs Defect Repair with Dehydrated Human Amnion/Chorion Membrane

Contact Info

Product

Resources

About