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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.
Objective:
To describe the trends in second-intention healing (SIH) use at a single Mohs micrographic surgery (MMS) dermatology clinic and assess outcomes and patient satisfaction.
Methods:
The authors conducted a single-center, retrospective study of patients who underwent MMS from November 2012 through November 2018. Data obtained for each patient included sex, age, tumor characteristics, number of MMS stages, final defect size, and postoperative complications. Patient satisfaction of SIH was retrospectively assessed by telephone survey.
Results:
Providers used SIH in 22% of all MMS cases (n = 159/718). It was most commonly used for defects located on the nose, ear, temple, and periocular region. The average defect size and number of MMS stages for tumor clearance were 1.3 cm and 1.5 stages, respectively. Overall, low rates of postoperative complications were observed, and 95% of patients reported optimal or acceptable levels of satisfaction.
Conclusions:
This study supports the idea that SIH is a safe, effective alternative for wound management and may have broader practice indications than those traditionally proposed.
