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Primary Closure Lengths in MMS Based on Cancer Type

Dermatolog Surg; ePub 2018 Jun 8; Theroux, et al

Preoperative lesion circumference is directly proportional to primary closure length and is a better indicator of closure length than preoperative area and short axis for Mohs micrographic surgery (MMS) of nonmelanoma skin cancers (NMSCs), according to a recent study. Closure lengths located on the nasal tip, supratip, or periocular areas are most sensitive to differences in NMSC size. Therefore, these data might aid Mohs surgeons with preoperative planning for wound reconstruction and patient counseling. A retrospective study of 4,049 NMSCs treated with MMS and repaired with primary linear closure was conducted. Primary closure lengths were plotted against preoperative lesion circumference, area, and short axis length. Linear regression analysis was performed. Researchers found:

  • Preoperative NMSC circumference correlated best with closure length.
  • 21 of the 28 regression models had coefficients of determination (R2) above 0.5.
  • Closure lengths increased by 0.52 to 1.1 mm, depending on location, for every millimeter increase in preoperative NMSC circumference.

Theroux ZA, Blechman AB, Russell MA. A predictive model for primary closure lengths in Mohs surgery based on skin cancer type, dimensions, and location. [Published online ahead of print June 8, 2018]. Dermatolog Surg. doi:10.1097/DSS.0000000000001571.