Chemosurgical report: indications for a geometric approach to wound closure following Mohs surgery

Complex geometrically designed closures of defects following tumor removal by Mohs surgery are often utilized when simpler methods of direct tissue aposition would suffice. There are, however, specific advantages in certain instances of using a preplanned geometric closure. Utilization of the secondary defect created by movement of a rotation flap permits redirection of the forces of tension of wound closure. Preplanning of advancement flaps allows for selective placement of tissue dog ears and thereby allows for maximal camouflaging of excisional scars. The dynamics of these two flaps are discussed and specific examples illustrating the principles are reviewed.