Autologous Patch Healing vs Secondary Intent Healing after Mohs Micrographic Surgery: A Randomized Controlled Trial

Area of Science:

• Dermatology
• Wound Healing Research
• Surgical Oncology

Background:

• Secondary intent healing is a common method for facial wound closure after Mohs micrographic surgery.
• This method, while effective, can lead to prolonged healing times, infection risks, and scarring complications.
• Autologous blood patches present a potential method to enhance wound healing.

Purpose of the Study:

• To evaluate the efficacy and safety of using an autologous blood patch for wound healing after Mohs micrographic surgery.
• To compare wound healing outcomes between secondary intent healing and autologous patch application.
• To assess factors like epithelialization, transepidermal water loss, and scar quality.

Main Methods:

• A randomized controlled assessor-blinded trial involving 22 patients undergoing Mohs micrographic surgery for facial tumors.
• Wound assessment included clinical evaluation at specific intervals (day 12, day 19, 6 months), transepidermal water loss measurements, and reflectance confocal microscopy.
• The Patient and Observer Scar Assessment Scale was used for scar evaluation at 6 months.

Main Results:

• Both groups achieved full epithelialization by day 19, with one wound in each group meeting the primary outcome.
• Wound area reduction was greater in the autologous patch group, though not statistically significant.
• A more significant decrease in transepidermal water loss was observed in the patch group, suggesting a moist wound environment.

Conclusions:

• Wound healing with an autologous patch is equivalent to secondary intent healing after Mohs surgery.
• The autologous patch may offer benefits in specific wound healing parameters and appears safe.
• High patient satisfaction was reported with the autologous patch healing method.