PDF herunterladen
Facial Plast Surg 2012; 28(03): 358-366
DOI: 10.1055/s-0032-1312691
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Successes, Revisions, and Postoperative Complications in 446 Mohs Defect Repairs

Anthony P. Sclafani
1   Division of Facial Plastic Surgery, The New York Eye & Ear Infirmary, New York, New York
2   Department of Otolaryngology–Head & Neck Surgery, New York Medical College, Valhalla, New York
3   Center for Facial Plastic Surgery, Chappaqua, New York
,
James A. Sclafani
3   Center for Facial Plastic Surgery, Chappaqua, New York
,
Anthony M. Sclafani
3   Center for Facial Plastic Surgery, Chappaqua, New York
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
21. Juni 2012 (online)

   Lizenzen und Reprints

Abstract

Objective To determine factors predictive of complications and the need for adjunctive treatments repair of facial Mohs defects.

Methods Charts of patients undergoing repair of facial defects from 2000 to 2010 in an academic facial plastic surgery practice were reviewed for patient medical history, tumor type, defect site and size, method of repair, postoperative sequelae, and adjunctive treatments.

Results A total of 446 Mohs defect repairs were analyzed. Average patient age was 61.54 ± 14.81 years. The average defect size was 17.55 ± 10.48 mm. Overall complications were fairly uncommon and required intervention in only 18.74%; other than postoperative corticosteroid injections, additional procedures were necessary in only 6.95% of patients. Female sex; Fitzpatrick skin type 3; upper lip and nasal defects; glabellar, superiorly based nasolabial, bilobed, and rhombic flaps; and dermal suture extrusion were associated with increased complications. The most common complications seen were scar erythema and flap pincushioning. The most common revision techniques performed/recommended were selective laser photothermolysis (3.59%) and scar excision (3.59%).

Conclusion Repair of Mohs defects uncommonly requires adjunctive/revision techniques to reach satisfactory appearance. By understanding certain factors related to the patient, the defect, and the method of repair, surgeons can better choose reparative techniques and anticipate patient postoperative needs.

Keywords

local flap - Mohs defect - complications
 

  • References

  • 1 Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg 1985; 76: 239-247
    CrossrefPubMedGoogle Scholar
  • 2 Burget GC, Menick FJ. Nasal reconstruction: seeking a fourth dimension. Plast Reconstr Surg 1986; 78: 145-157
    CrossrefPubMedGoogle Scholar
  • 3 Burget GC, Menick FJ. Nasal support and lining: the marriage of beauty and blood supply. Plast Reconstr Surg 1989; 84: 189-202
    CrossrefPubMedGoogle Scholar
  • 4 Burget GC. Aesthetic Reconstruction of the Nose. 2nd ed. St. Louis: Mosby, Inc.; 1993
    Google Scholar
  • 5 Baker SR. Local Flaps in Facial Reconstruction, 2nd ed. St. Louis: Mosby, Inc.; 2007
    Google Scholar
  • 6 Sherris D, Larrabee WF eds. Principles of Facial Reconstruction: A Subunit Approach to Cutaneous Repair, 2nd ed. New York: Thieme; 2009
    Google Scholar
  • 7 Dzubow LM. The dynamics of flap movement: effect of pivotal restraint on flap rotation and transposition. J Dermatol Surg Oncol 1987; 13: 1348-1353
    CrossrefPubMedGoogle Scholar
  • 8 Dzubow LM. Repair of defects on nasal sebaceous skin. Dermatol Surg 2005; 31 (8 Pt 2) 1053-1054
    PubMedGoogle Scholar
  • 9 Collins SC, Dufresne Jr RG, Jellinek NJ. The bilobed transposition flap for single-staged repair of large surgical defects involving the nasal ala. Dermatol Surg 2008; 34: 1379-1385 ; discussion 1385–1386
    CrossrefPubMedGoogle Scholar