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Reconstructive methods in Mohs micrographic surgery in Uruguay: A bidirectional descriptive cohort analysis.
J Navarrete1, J Magliano1, M Martínez1
1Cátedra de Dermatología Prof. Dr. Miguel Martínez, Hospital de Clínicas Dr. Manuel Quintela, Universidad de la República, Montevideo, Uruguay.
Actas Dermo-Sifiliograficas
|December 19, 2017
Summary
Mohs micrographic surgery (MMS) involves complete cancer excision and various wound closure methods. Cosmetic outcomes are influenced by defect size and location, not patient factors, guiding reconstructive technique selection.
Area of Science:
- Dermatology
- Surgical Oncology
- Plastic Surgery
Background:
- Mohs micrographic surgery (MMS) is a precise technique for complete cancerous lesion excision.
- Diverse reconstructive techniques are employed for wound closure following MMS.
Purpose of the Study:
- To descriptively analyze patients undergoing MMS, focusing on wound closure methods.
- To evaluate cosmetic outcomes and identify factors influencing them.
Main Methods:
- A bidirectional descriptive cohort analysis of 100 MMS procedures by a single surgeon (Nov 2013-Apr 2016).
- Photographic assessment of cosmetic outcomes by a dermatologist after a 90-day minimum follow-up.
Main Results:
- Analysis included 71 patients (median age 73) with basal cell carcinoma (70%) and squamous cell carcinoma (29%), predominantly on the head and neck (75%).
- Reconstructive techniques included flap closure (48%), simple closure (36%), and second intention (11%).
- Excellent to good cosmetic outcomes were achieved in 80% of assessed procedures, but worse outcomes correlated with larger defects, trunk location, and specific closure methods.
Conclusions:
- While simple closure was favored for trunk lesions and smaller defects, reconstructive technique choice requires individualized consideration.
- Clinical, tumor-related factors, and surgeon preference are crucial in selecting the optimal reconstructive approach post-MMS.
