Wound Healing Complications Associated with Staged Reconstruction after Facial Lentigo Maligna Resection

Area of Science:

• Dermatologic Surgery
• Plastic Surgery
• Oncology

Background:

• Wound complication rates and risk factors after staged reconstruction for facial lentigo maligna (LM) are not well-established.
• Understanding these factors is crucial for optimizing patient outcomes.

Purpose of the Study:

• To determine the incidence and types of wound complications within 30 days of staged reconstruction for facial LM.
• To identify a critical defect size threshold predictive of wound complications.

Main Methods:

• Retrospective review of 98 patients undergoing staged reconstruction for facial LM over 5 years.
• Analysis of surgeon's clinical notes for wound complications including infection, necrosis, hematoma, epidermolysis, and seroma.
• Statistical analysis to identify risk factors and predictive defect size.

Main Results:

• A 26% complication rate was observed in 98 patients, with wound infection (36%) and graft necrosis (24%) being most common.
• Perioperative antibiotic use was associated with significantly lower complication rates (OR: 0.36; 95% CI: 0.13, 0.96; p=0.041).
• Defects exceeding 2.7 cm in maximal diameter showed high sensitivity for predicting complications.

Conclusions:

• Staged reconstruction for facial LM carries a substantial risk of wound complications (26%).
• Perioperative antibiotics may mitigate complication risk.
• A defect size greater than 2.7 cm is a significant risk factor for adverse wound events.