Keep it simple. A ten-year experience in reconstructions after Mohs micrographic surgery

Area of Science:

• Dermatology
• Surgical Oncology
• Plastic Surgery

Background:

• Mohs micrographic surgery is a standard treatment for skin cancers globally.
• Selecting the optimal closure technique post-Mohs surgery can be complex.
• Reconstruction choices depend on tumor characteristics and surgical requirements.

Purpose of the Study:

• To correlate surgical reconstruction types after Mohs surgery with tumor factors.
• To analyze associations between closure methods, tumor histology, location, and number of surgical stages.

Main Methods:

• Retrospective analysis of 975 medical records from facial and extra-facial cases.
• Data collected included patient demographics, tumor location, histology, number of Mohs stages, and repair type.
• Statistical analysis using Poisson regression to compare closure frequencies.

Main Results:

• Linear closure was the most frequent repair (39%), associated with fewer Mohs stages.
• Nasal defects showed a 39% higher frequency of non-primary closures compared to other sites (p<0.05).
• Defects requiring two or more stages had a 28.6% higher frequency of non-primary closures (p<0.05).

Conclusions:

• The choice of closure after Mohs surgery can be influenced by tumor complexity and location.
• Primary closure remains a viable option, particularly for simpler defects and non-aggressive tumors.
• Further research is needed to fully elucidate factors influencing reconstruction decisions.