Association Between Type of Reconstruction After Mohs Micrographic Surgery and Surgeon-, Patient-, and Tumor-Specific Features: A Cross-Sectional Study

Alam, Murad; Helenowksi, I.; Cohen, Joel L.; Levy, Ross M.; Liégeois, Nanette J.; Mafong, Erick A.; Mooney, Maureen A.; Nehal, Kishwer S.; Nguyen, Tri H.; Ratner, Désirée; Rohrer, Tom E.; Schmults, Chrysalyne D.; Tan, Stephen; Yoon, Jaeyoung; Kakar, Rohit; Rademaker, Alfred; White, Lucile E.

doi:10.1111/dsu.12045

Cited by 16 publications

(13 citation statements)

References 6 publications

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“…We have found that the use of grafts and second intention techniques is more common in the SCC group, which is consistent with some studies that found that the techniques of closure most often used for reconstructing MMS defects are linear closures 32 and flaps. 1,33 However, these studies do not distinguish between BCC and SCC reconstruction.…”

Section: Discussionsupporting

confidence: 91%

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

et al. 2018

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Background The two main tumors treated with Mohs micrographic surgery (MMS) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). There are no studies analyzing whether MMS is different when treating these two types of tumors. Objective We aim to compare the characteristics of the patients, the tumors, and MMS, and first‐year follow‐up of MMS in BCC and SCC. Methods REGESMOHS is a prospective cohort study of patients treated with MMS. The participating centers are 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patients, tumors, and surgery were recorded. The follow‐up was done with two visits: the first visit within 1 month after surgery and the second one within the first year. Results From July 2013 to April 2017, a total of 2,669 patients who underwent MMS were included in the registry. Of them, 2,448 (93%) were diagnosed with BCC, and 181 (7%) were diagnosed with SCC. Patients with SCC were older than those with BCC (median age 73 years vs. 68 years) and presented immunosuppression more frequently. The tumor size was significantly larger in the SCC group. Regarding surgery, deeper invasion was more frequent in SCC, resulting in larger defects. Despite this, SCC did not require more stages to get clear margins or more time in the operating room. Incomplete Mohs was more frequent in the SCC group (6%) than in the BCC group (2%). The incidence of perioperative complications was higher when treating SCC. There were more relapses in the first‐year follow‐up in the SCC group. Conclusion There are significant differences when comparing MMS in BCC and SCC. Knowledge of these differences can help to prepare the patient and plan the surgery, optimizing results.

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Section: Discussionsupporting

confidence: 91%

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

et al. 2018

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“…Most Mohs defects were closed by primary suturing in this study and that of Alam et al . [ 45 ] Flaps and grafts were seen increasingly after more than two Mohs stages. [ 45 ] This was the same in the present study.…”

Section: Discussionmentioning

confidence: 99%

Basal cell carcinoma of the outer nose: Overview on surgical techniques and analysis of 312 patients

Wollina¹,

Bennewitz²,

Langner³

2014

J Cutan Aesthet Surg

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Background:Basal cell carcinoma of the nose is common, with a potential of local recurrence and high-risk features.Materials and Methods:We provide a review on anatomy of the nose, tumour surgery and defect closure on the nose. We analysed our own patients with nasal BCC of a 24 months period.Results:We identified 321 patients with nasal BCC. There was a predominance of female patients of 1.2 to 1. The mean age was 74.8 years. Slow Mohs technique was employed for all tumours until 3D tumour-free margins were achieved. That resulted on average in 1.8 ± 0.7 Mohs stages. The most common histologic types were solitary (n = 182), morpheic (79), and micronodular (20), Perineural infiltration was evident in 56 tumours. Primary closure after mobilisation of soft tissue was possible in 105 BCCs. Advancement flaps were used in 91 tumours, rotation flaps in 47, transposition flaps in 34 tumours, and combined procedures in 6 cases. In 36 patients full-thickness skin grafting was performed. In two patients healing by second intention was preferred. Partial flap loss was seen in four patients (1.4%). All of them had significant underlying pathologies. None of the tumours treated showed a relapse during the observation time. However, this is a limitation of the present study since follow-up was on average only 10 months.Conclusions:BCCs of the nose are common. Only 3D-controlled micrographic surgery (Mohs or slow Mohs) guarantee a high rate of complete tumour removal and a very low risk of recurrence.

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“…It is also to look like a face [37]. Physical attractiveness positively correlates with social success and directly impacts how a person is treated [38][39][40]. While a small flap closure is technically straightforward, a large nasal reconstruction with a forehead flap, cartilage grafting, and nasal lining reconstruction is more complex and comprised of a large number of steps that all need to be completed flawlessly.…”

Section: When Reconstruction Cannot Be Completed By Dermatologist Promentioning

confidence: 99%

Interdisciplinary Surgical Management of Skin Cancer: the Saint Louis University Experience

et al. 2015

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While the vast majority of skin cancers can be managed by a single practitioner in the outpatient setting, there is a subset of complex skin cancers that benefit from multidisciplinary care. At our institution, we have built strong collegial relationships with allied specialties such as surgical oncology, otolaryngology-head and neck surgery, plastic surgery, facial plastic surgery, and oculoplastic surgery. It is common for patients with high-risk or complex tumors to be seen preoperatively by several allied specialties. This allows for care coordination and more seamless care in addition to fostering skin cancer expertise within our collaborators in allied specialties.

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Association Between Type of Reconstruction After Mohs Micrographic Surgery and Surgeon-, Patient-, and Tumor-Specific Features: A Cross-Sectional Study

Abstract: Most post-Mohs closures are linear repairs, with more bilayered linear repairs more likely at certain anatomic sites and after a larger number of stages.

Cited by 16 publications

References 6 publications

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

Basal cell carcinoma of the outer nose: Overview on surgical techniques and analysis of 312 patients

Interdisciplinary Surgical Management of Skin Cancer: the Saint Louis University Experience

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