Mohs Defect Repair with Dehydrated Human Amnion/Chorion Membrane

Area of Science:

• Dermatology
• Plastic Surgery
• Regenerative Medicine

Background:

• Reconstructing defects from Mohs micrographic surgery (MMS) in aging patients presents challenges, especially in cosmetically sensitive areas.
• Traditional reconstruction methods include autologous tissue procedures like flaps and full-thickness skin grafts (FTSG).
• Exploring alternatives to surgery is crucial for managing complex reconstructions.

Purpose of the Study:

• To compare the safety and efficacy of placental allografts versus traditional autologous tissue procedures for MMS defect reconstruction.
• To evaluate postoperative morbidity and cosmetic outcomes in visually prominent areas.

Main Methods:

• Retrospective case-control study of patients undergoing MMS with same-day repair.
• Propensity score-matching of 143 pairs (n=286) with moderate-to-high risk facial, head, and neck defects.
• Comparison of postoperative complication rates, including infection, scar cosmesis, scar revision, and reoperation.

Main Results:

• Placental allograft reconstructions showed significantly lower risks of infection (p=0.004) compared to autologous tissue.
• Lower incidence of poor scar cosmesis (p<0.0001), need for scar revision (p<0.0001), and reoperation (p=0.0007) with placental allografts.
• No significant difference in overall postoperative morbidity exceeded that of autologous tissue repairs.

Conclusions:

• Placental allografts are a safe and effective alternative for reconstructing cosmetically sensitive defects after Mohs surgery.
• This approach offers reduced complication rates compared to traditional flaps and FTSG.
• Placental allografts provide a viable option for improving patient outcomes in facial reconstruction.