Predicting outcomes following second intent healing of periocular surgical defects

Kibbi, Nour; Khan, Yulia; Leffell, David J.; Christensen, Sean R.; Suozzi, Kathleen C.

doi:10.1007/s00403-020-02122-w

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…118 Low-level retrospective chart reviews have concluded that small, partial-thickness defects of the lower eyelid heal well by secondary intention. 119,120 Interestingly, in one retrospective study, defects located on the medial canthus had worse cosmetic outcomes when allowed to heal secondarily. 119,120 This, however, differs from the classic thought that concave surfaces heal well secondarily, and further larger higher level evidence is necessary to confirm this finding.…”

Section: Periocular Defectsmentioning

confidence: 99%

State of the Evidence for Facial Skin Cancer Reconstruction

et al. 2023

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This review provides a comprehensive presentation of the evidence available in facial reconstruction post-Mohs Micrographic Surgery. Given the large diversity in post-Mohs reconstruction, there are limited guidelines in the management of defects. The aim of the present work is to provide a review of the best evidence as it pertains to several considerations in facial reconstruction. Data suggests that Mohs Micrographic Surgery and many reconstructive procedures can be performed as outpatient procedures under local anesthesia, with narcotic pain medication only given in certain patient populations following a minority of reconstructive procedures. Perioperative and topical antibiotics are generally not indicated. Aspirin and Warfarin can generally be continued for most reconstructive procedures, but clopidogrel and novel anticoagulants may predispose to increased bleeding complications. Delayed reconstruction appears to be safe, although data is discordant on this topic. No specific wound closure technique or suture choice appears to be consistently superior. Given the lack of robust comparative studies, consistent methodology, and variable defect sizes/ locations, no robust evidence-based guidelines can be generated for reconstruction techniques of facial subsites.

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Section: Periocular Defectsmentioning

confidence: 99%

State of the Evidence for Facial Skin Cancer Reconstruction

et al. 2023

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“…It also can facilitate better contour restoration by preventing graft depression, decrease bleeding and exudation, and decrease the chance of hematoma or seroma when compared to immediate repair. 23,48,49 Allowing time for granulation formation also leads to wound contraction which will make the final wound smaller and presumably easier to repair. 22,50,51…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Time to Mohs Reconstruction: A Systematic Review Comparing Complication Rates between Immediate and Delayed Repair

et al. 2023

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Background: Several known factors affect outcomes of Mohs facial defect reconstruction; however, the effect of repair timing on outcomes is ill-defined. Objective: To determine postoperative complication rates between immediate and delayed repair of Mohs facial defects. Design/Methods: Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines were used. Articles were selected using PICO format – population: Mohs facial defect patients, intervention: defect repair, comparator: immediate (<24 hours) or delayed (>24 hours) repair, outcome: complication rate. PubMed/Medline (1946-2020), EMBASE (1947-2020), Scopus (1823-2020), Web of Science (1900-2020), Cochrane Library, and Clinicaltrials.gov were searched. Two independent reviewers screened abstracts; those in English with human subjects reporting repair timing and complication rates were included. Results: Search criteria yielded 6649 abstracts; 233 qualified for review. Data were gathered from six studies; they alone contained comparative data meeting inclusion criteria. While many well-written studies were encountered, reported results varied widely. A statistically sound meta-analysis could not be completed due large heterogeneity between studies, biasing the analysis towards the largest weighted study. Conclusions: Clinically important differences may exist between immediate and delayed Mohs reconstruction, but small study numbers, large heterogeneity, and lack of standardized outcome measures limit definitive conclusions. More studies are needed to perform appropriate meta-analyses, including studies using standardized methods of reporting Mohs outcome data.

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