Related Experiment Videos
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.
Background:
Lower extremity wounds present a major clinical challenge.
Objective:
This paper introduces a new multistep approach for improved aesthetic and functional outcome for lower extremity wound closure after Mohs micrographic surgery.
Patients And Methods:
In this prospective case series, 12 consecutive patients undergoing Mohs micrographic surgery for cutaneous malignancies of the lower extremities underwent closure assisted by elastic bandages, proper positioning with 45° flexion of the knee, buried vertical mattress sutures, and careful eversion, using a premium angled stapler. Assessment of cosmetic outcome was performed by 2 blinded observers, using the Hollander Wound Evaluation Scale.
Results:
The mean age was 73 ± 9 years with most patients having at least one comorbidity. Six patients (50%) underwent resection of a basal cell carcinoma and 5 patients (42%) underwent resection of a squamous cell carcinoma and 1 patient (8%) underwent resection of a keratoacanthomatous carcinoma. There were no wound complications, and at the 3- to 6-month follow-up, 11 of the 12 wounds (92%) had an optimal Hollander Wound Evaluation Scale score of 6.
Conclusion:
This new approach to lower extremity wounds provides excellent cosmetic outcome with no reported complications.