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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Evidence-Based Clinical Practice Guideline: Reconstruction after Skin Cancer Resection
Andrew Chen1, John G Albertini1, Jeremy S Bordeaux1
1From the University of Connecticut; The Skin Surgery Center; University Hospitals Cleveland Medical Center/Case Western Reserve University; Kaiser Permanente; Duke University Medical Center; American Society of Plastic Surgeons; Galaria Plastic Surgery and Dermatology; Veterans Affairs Medical Center; Florida Center for Dermatology; Department of Dermatology, University of Pennsylvania Perelman School of Medicine; private practice; Cooper Medical Center, Rowan University; University of South Florida; University of Central Florida; University of California, Irvine; Piedmont Plastic Surgery and Dermatology; Pennsylvania State University; Rush University Medical Center; University of Illinois at Chicago; R. L. Roudebush Veterans Affairs Medical Center; University of California, Davis, Medical Center; University of Iowa Hospitals & Clinics; private practice; and Northwestern University.
Summary:
A multi-disciplinary work group involving stakeholders from various backgrounds and societies was convened to develop guidelines for the management of reconstruction after skin cancer resection. The goal was to identify areas of common ground and provide evidence-based recommendations to improve patient care. Given the heterogeneity of reconstructive techniques and clinical scenarios, investigation centered around common elements in the process. In some cases, a distinction was made between treatment options in the office-based setting as opposed to those in the facility setting. A systematic literature review was performed, and an established appraisal process was used to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development, and Evaluation methodology). Final recommendations are related to concepts concerning the timing of reconstruction, management of anticoagulation, use of antibiotics, methods of pain control, and follow-up assessment. At times, there was insufficient evidence to make high-level recommendations. The literature analysis highlights the need for additional methodologically robust studies in this area, to help guide clinical practice.
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