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Second-Intention Healing in Mohs Micrographic Surgery: A Single-Center Academic Experience
Julián Barrera-Llaurador1, Osward Y Carrasquillo, Marely Santiago-Vázquez
1Julián Barrera-Llaurador, MD, is Dermatology Assistant Professor, Department of Dermatology, University of Puerto Rico School of Medicine, San Juan. Osward Y. Carrasquillo, MD, MPH, is Mohs Micrographic Surgery Fellow, Department of Dermatology, University of North Carolina, Chapel Hill. Marely Santiago-Vázquez, MD, is Dermatology Resident, Department of Dermatology, University of Puerto Rico School of Medicine. Valeria J. González-Molina, MD, is Clinical Fellow, Department of Dermatology, HCA Corpus Christi Medical Center-Bay Area, Texas. Sheila M. Valentín-Nogueras, MD, is Mohs Micrographic Surgeon, Director of Dermatologic Surgery, Department of Dermatology, University of Puerto Rico School of Medicine. The authors have disclosed no financial relationships related to this article. Submitted August 18, 2021; accepted in revised form January 10, 2022.
Second-intention healing (SIH) is a safe and effective wound management option after Mohs micrographic surgery (MMS), with high patient satisfaction and low complication rates.
Area of Science:
- Dermatology
- Surgical Oncology
- Wound Healing
Background:
- Mohs micrographic surgery (MMS) is a specialized technique for skin cancer removal.
- Second-intention healing (SIH) is a wound management method involving natural healing.
- Understanding SIH trends and outcomes in MMS is crucial for optimizing patient care.
Purpose of the Study:
- To analyze the utilization patterns of SIH following MMS procedures.
- To evaluate the clinical outcomes and patient satisfaction associated with SIH.
- To assess the safety and efficacy of SIH as a wound closure alternative.
Main Methods:
- Retrospective analysis of 159 patients undergoing MMS from November 2012 to November 2018.
- Data collection included patient demographics, tumor characteristics, defect size, and MMS stages.
- Patient satisfaction with SIH was assessed via telephone survey.
Main Results:
- SIH was employed in 22% of all MMS cases, predominantly for facial defects (nose, ear, temple, periocular).
- Average defect size was 1.3 cm, with an average of 1.5 MMS stages for tumor clearance.
- Low complication rates were observed, and 95% of patients reported satisfactory outcomes.
Conclusions:
- Second-intention healing is a safe and effective wound management strategy after MMS.
- SIH may be applicable to a wider range of defects than traditionally considered.
- This approach offers a favorable alternative for wound closure, enhancing patient satisfaction.
