Scars after second intention healing.

Area of Science:

• Dermatology
• Plastic Surgery
• Wound Healing

Background:

• Second intention healing (SIH) is a valuable technique for managing defects after skin cancer removal.
• It offers benefits such as reduced intraoperative morbidity and lower procedure costs.
• SIH is associated with low rates of infection, pain, and bleeding, simplifying wound care.

Purpose of the Study:

• To review the literature on SIH based on facial anatomy.
• To understand how anatomical location influences cosmetic outcomes of SIH.
• To highlight the advantages and potential complications of SIH.

Main Methods:

• Literature review focusing on SIH and facial anatomy.
• Categorization of facial regions into concavities (NEET), convexities (NOCH), and flat areas (FAIR).
• Analysis of cosmetic outcomes based on defect location.

Main Results:

• Cosmetic outcomes of SIH are highly dependent on the anatomical location of the defect.
• Concave facial areas (e.g., medial canthus, conchal bowl) often heal imperceptibly.
• Convex surfaces (e.g., nasal tip, malar cheek) may result in poor healing and depressed scars, while flat areas show unpredictable cosmesis.

Conclusions:

• SIH is a viable reconstructive option after skin cancer excision, with location being a critical factor for cosmetic results.
• Understanding facial topography (NEET, NOCH, FAIR) aids in predicting SIH outcomes.
• Surgeons should consider SIH as part of their reconstructive algorithm, being aware of potential complications like exuberant granulation or scar distortion.