New trends in skin tumor surgery

Over 8 years, 1700 patients were referred from the Mohs' Surgery and Cutaneous Laser Unit after Mohs micrographic skin tumor excision to the Division of Plastic and Reconstructive Surgery. Preoperative coordination between the two divisions was emphasised in wound preparation and timing of reconstruction for maximized patient convenience and outcome. Most repairs of facial and extremity defects were carried out under local anesthesia. Techniques of repair were selected based upon algorithmic priorities emphasizing simple techniques over complex ones. Direct closure, skin grafts and flaps were used. Preference for aesthetic subunit reconstruction of the face and the use of particular flap techniques including the O-to-S, O-to-T, V-to-Y island advancement, islandized nasolabial flap for alar reconstruction and the forehead flap for nasal dorsum and tip repair are illustrated.