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Multistep Approach for Improved Aesthetic and Functional Outcomes for Lower Extremity Wound Closure After Mohs
Elizabeth Kiwanuka1, Antonio P Cruz
1*Department of Plastic Surgery, Rhode Island Hospital and Warren Alpert Medical School, Brown University, Providence, Rhode Island; †Skinpros, LLC, Providence, Rhode Island; ‡Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
Summary
A new multistep approach for lower extremity wound closure after Mohs surgery offers excellent cosmetic results. This technique achieved optimal outcomes in 92% of patients with no complications, improving wound healing.
Area of Science:
- Dermatology
- Plastic Surgery
- Wound Healing
Background:
- Lower extremity wounds pose significant clinical challenges.
- Mohs micrographic surgery for cutaneous malignancies requires effective closure techniques.
Purpose of the Study:
- To introduce a novel multistep approach for lower extremity wound closure.
- To enhance aesthetic and functional outcomes following Mohs surgery on the lower extremities.
Main Methods:
- A prospective case series of 12 patients undergoing Mohs surgery for lower extremity cutaneous malignancies.
- Closure involved elastic bandages, specific knee positioning (45° flexion), buried vertical mattress sutures, and eversion using an angled stapler.
- Cosmetic outcome was assessed by blinded observers using the Hollander Wound Evaluation Scale.
Main Results:
- The study included 12 patients with a mean age of 73 years, many with comorbidities.
- Common malignancies included basal cell carcinoma (50%) and squamous cell carcinoma (42%).
- No wound complications were reported, and 92% of wounds achieved an optimal score (6) on the Hollander Wound Evaluation Scale at 3- to 6-month follow-up.
Conclusions:
- The novel multistep approach yields excellent cosmetic outcomes for lower extremity wounds.
- This technique demonstrated a high success rate with no reported complications.