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Patient Satisfaction With Second-Intention Healing in Mohs Micrographic Surgery: A Systematic Review
Chase A Pitchford1, Christian E Hemmerich2, Andrew S Desrosiers3
1Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Background:
Second-intention healing (SIH) has been a cornerstone of Mohs micrographic surgery (MMS) for defect closure. However, advancements in reconstructive techniques have reduced its use, despite evidence supporting its efficacy in appropriately selected cases. Although physician-reported outcomes are well established, patient-reported (PR) perspectives on SIH remain underexplored.
Objective:
To systematically review patient satisfaction and reported outcomes after SIH in MMS.
Materials And Methods:
A systematic literature search was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, using databases including PubMed and EMBASE. Studies assessing PR satisfaction, cosmetic outcomes, healing experiences, and functional results of SIH after MMS were included. Data extraction and quality assessment were performed independently by 2 reviewers (C.H. and C.P.).
Results:
Eight studies met the inclusion criteria. PR satisfaction/outcomes with SIH were high, with favorable cosmetic and functional outcomes. Minor complications were reported, but did not significantly affect overall satisfaction. However, variability in outcome assessment methods, particularly the use of nonvalidated scoring systems, limits comparability across studies.
Conclusion:
SIH remains a valuable reconstructive option in MMS, offering high patient satisfaction in select cases. Standardization of PR outcome measures is needed to enhance comparability and optimize decision making in dermatologic surgery.
