Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Mohs Defect Healing by Secondary Intention Weighed

Dermatol Surg; ePub 2016 Dec 29; Vedvyas, et al

Broader indications for secondary intention (SI) healing of Mohs surgical defects may be more appropriate than previously understood, a recent study found. In addition to concave, temporal, periocular, perinasal, and periauricular sites, SI healing may be appropriate for convex sites such as the scalp and anterior lower extremity, deep wounds, and large wounds, as well as wounds with dehiscence, flap necrosis, or infection. Researchers conducted an email survey using data from the American College of Mohs Surgery in 2015 (n=293 respondents). They found:

  • The most experienced surgeons were significantly more likely to heal deep and larger wounds secondarily.
  • Many surgeons elect SI healing in patients with current or previous wound dehiscence, flap necrosis, or infection; in patients who have undergone skin cancer excisions before, or who are elderly, and; if the lesion was sent for permanent section, or when treating high-risk, large, recurrent, or aggressive tumors.

Citation:

Vedvyas C, Cummings PL, Geronemus RG, Brauer JA. Broader practice indications for Mohs surgical defect healing by secondary intention: A survey study. [Published online ahead of print December 29, 2016]. Dermatol Surg. doi:10.1097/DSS.0000000000000998.

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