Cosmetic and Functional Outcomes of Second Intention Healing for Mohs Defects of the Lips

The lips are a common location for skin cancer and thus for Mohs micrographic surgery (MMS). There are few studies looking at second intention healing of Mohs defects of the lips, and none have used a scar assessment scale.

To evaluate the acceptability of second intention healing of the vermilion lips following MMS using a patient questionnaire and the Patient and Observer Assessment Scale (POSAS).

Eligible patients were found through chart review. A patient questionnaire and the patient scale of the POSAS were performed over the phone. For patients who were able to come to clinic, the observer scale of the POSAS was performed.

Forty-seven phone interviews and 21 clinic assessments were performed. Overall, patients noted excellent functional outcomes, and good to excellent cosmetic outcomes, and were satisfied with healing time. There was not a significant difference between the patient and observer total scores (p = .63) or overall scores (p = .59).

Second intention healing can have satisfactory functional and cosmetic outcomes and healing times with few complications and should be considered for surgical defects on the vermilion lips as large as 2.8 cm even when there is involvement of the cutaneous lip and muscular layer.