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Linear closure for nasal defects after Mohs micrographic surgery.

Adam J Mamelak1, Steven Q Wang, Leonard H Goldberg

  • 1DermSurgery Associates, Houston, TX 77030, USA.

Journal of Drugs in Dermatology : JDD
|February 3, 2009
PubMed
Summary

Linear closure (LC) effectively repairs nasal defects after Mohs micrographic surgery (MMS). This method offers excellent cosmetic and functional outcomes for small to mid-sized skin cancers on the nose.

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Area of Science:

  • Dermatology
  • Plastic Surgery
  • Oncology

Background:

  • Nasal skin cancers are common, and their surgical excision often results in defects that are challenging to repair.
  • Mohs micrographic surgery (MMS) is a common treatment for skin cancers on the nose, frequently leading to surgical defects.

Purpose of the Study:

  • To evaluate the authors' experience using linear closures (LC) for repairing nasal defects following MMS.
  • To assess the cosmetic outcomes of LC compared to flaps and grafts for nasal defect repair.

Main Methods:

  • Retrospective analysis of 2053 patients undergoing LC for nasal defects after MMS (July 1997-January 2006).
  • Evaluation of defect size, closure length, malignancy type, defect location, and complications.
  • Prospective assessment comparing cosmetic outcomes of LC versus flaps/grafts for nasal defects.

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Main Results:

  • LC was used on 2053 patients for nasal defects averaging 1.7 x 0.9 cm.
  • Basal cell carcinoma and squamous cell carcinoma were the most common malignancies treated.
  • Short-term complications were minimal, with occasional asymmetry that improved over time. Cosmetic outcomes for LC were rated higher than flaps/grafts, though not statistically significant.

Conclusions:

  • Vertical or slightly vertical linear closure is a reliable method for excellent cosmetic and functional results in nasal defects after MMS.
  • LC is a recommended technique for small to mid-sized cutaneous nasal defects post-MMS.