Successes, revisions, and postoperative complications in 446 Mohs defect repairs.
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%).


CONCLUSIONS
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.
Division of Facial Plastic Surgery, The New York Eye & Ear Infirmary, 310 E. 14th St., New York, NY 10003, USA. asclafani@nyee.edu
Anthony P
AP
Sclafani
James A
JA
Sclafani
Anthony M
AM
Sclafani
D000367:Age Factors; D002280:Basal Cell Carcinoma / Q000601:surgery; D002921:Cicatrix / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005145:Face / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008047:Lip Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000009:adverse effects* / Q000534:rehabilitation; D009668:Nose Diseases / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013524:Surgical Flaps / Q000145:classification / Q000473:pathology; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome