title: Safety of staged interpolation flaps after Mohs micrographic surgery in an outpatient setting: a single-center experience.
abstract: OBJECTIVE
  To establish the safety of staged interpolation flaps performed in an outpatient dermatologic clinic setting.
  
  
  METHODS
  A retrospective chart review was performed of patients who underwent staged interpolation flap reconstruction by a single dermatologic surgeon after tumor clearance using Mohs micrographic surgery from 2000 to 2012 at the Department of Dermatology, Medical University of South Carolina.
  
  
  RESULTS
  Six hundred fifty-three staged flaps were performed in 639 patients (mean age 65) between June 2000 and November 2012. Types of flaps included paramedian forehead flaps (n = 291, 45%), two-stage melolabial flaps (n = 256, 39%), retroauricular flaps (n = 58, 9%), interpolated paranasal flaps (n = 40, 6%), and Abbe or Abbe-Estlander flaps (n = 8, 1%). No major complications were observed. Of the minor complications, problems related to bleeding were the most prevalent; active bleeding requiring physician intervention was seen in 8.4% and hematoma formation in 0.4% of flaps. Postoperative infections were seen in 1.7% of patients after the initial surgery and 3.4% after division of the pedicle. Primary or secondary dehiscence was seen in 0.5%. Partial full-thickness flap necrosis was seen in 2.3% and total flap necrosis in 0.6%.
  
  
  CONCLUSIONS
  The rate of complications associated with dermatologic surgeons performing interpolated flaps in an outpatient setting under local anesthesia is low. Our complication rates are equal to or lower than published complication rates from other surgical specialties.
authors.affiliation: Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Tracey
authors.initials: T
authors.lastname: Newlove
authors.forename: Joel
authors.initials: J
authors.lastname: Cook
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009336:Necrosis; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery*; D000077195:Squamous Cell Carcinoma of Head and Neck; D013524:Surgical Flaps / Q000473:pathology; D055815:Young Adult