Mohs Surgeons' Postoperative Care Practices for Secondary Intention Healing: A National Survey

This paper seeks to characterize Mohs surgeons' postoperative wound care practices for secondary intention healing (SIH) and identify trends in the use of topical agents and perceived clinical outcomes.

A survey was distributed to American College of Mohs Surgery (ACMS) members to assess demographics, practice settings, wound care preferences, and self-reported outcomes related to SIH. Fisher's exact and χ² tests were used to evaluate associations between surgeon characteristics and wound care practices.

Petroleum emollients were used by 96.4% of respondents. Topical antibiotics, most commonly mupirocin and gentamicin, were routinely recommended by 36.1% and were associated with higher reported infection rates (P=0.034). Antiseptic solutions, particularly dilute acetic acid, were more often used by early-career surgeons (P=0.016). Only 10.8% of respondents used topical timolol. Conventional nonadherent dressings were preferred by 91.6% of respondents. Most surgeons reported complete healing within 4 to 8 weeks (72.3%), 95.2% of surgeons indicated infection rates of 5% or less, and 95.2% reported good to excellent cosmetic outcomes.

Low response rate and self-reported data limited generalizability. Wound location data were not stratified.

Postoperative care practices for SIH vary considerably among Mohs surgeons. Despite supporting literature, the use of advanced dressings, antiseptics, and topical timolol remains limited. These findings highlight opportunities for further research and standardization of SIH wound care.