Common patterns of reconstruction for Mohs defects in the head and neck.
BACKGROUND
Skin cancer is the most common of all cancers. Mohs surgery is an effective technique for removing common types of skin cancer. The number of patients presenting for reconstruction after Mohs surgery has been increasing in recent years. Reconstructive surgeons are faced with diverse defects of different sizes and locations. The aim of this study was to examine reconstructive methods for Mohs defects to aid in preoperative planning.


METHODS
We reviewed the charts of 245 patients who underwent Mohs defect reconstruction over a period of 5 years. The patients were categorized according to the reconstructive technique (eg, flap, full-thickness skin graft, split-thickness skin graft) used in relation to anatomic location and the size of the defect.


RESULTS
One hundred twenty-nine patients (53%) had Mohs defects of the nose. Bilobed flap reconstruction was the most common for the nasal ala (17/42 [40%]), tip (19/41 [46%]), and nasal sidewall (8/25 [32%]). Forehead flap reconstruction was most common for nasal dorsum defects (9/16 [56%]). Linear closure was the most common reconstructive technique for the cheek (18/34 [53%]), the forehead (13/20 [65%]), the chin (4/4 [100%]), the lower lip (4/4 [100%]), the upper lip (8/13 [38%]), the auricle (4/10 [40%]), the eyelid (5/8 [62%]), and the temporal region (2/5 [40%]). Composite grafting was the most common in the nasal columella (2/3 [67%]) and full-thickness skin graft for nasal sill defects (2/2 [100%]). Split-thickness skin graft was the most common in the scalp (3/6 [50%]).


CONCLUSIONS
Various options exist for Mohs repair. Understanding trends of reconstructing Mohs defects may help in planning the best method of reconstruction.
From the *Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; †Department of Otolaryngology, Ain Shams University, Cairo, Egypt; and ‡Borud Consulting, Miami, Florida.
Ahmed M S
AM
Ibrahim
Amr N
AN
Rabie
Loren
L
Borud
Adam M
AM
Tobias
Bernard T
BT
Lee
Samuel J
SJ
Lin
D000328:Adult; D000368:Aged; D002610:Cheek / Q000601:surgery; D002680:Chin / Q000601:surgery; D054644:Ear Auricle / Q000601:surgery; D004428:Ear Neoplasms / Q000601:surgery; D005142:Eyelid Neoplasms / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D005546:Forehead / Q000601:surgery; D006801:Humans; D008048:Lip Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000534:rehabilitation*; D009300:Nasal Septum / Q000601:surgery; D009333:Neck / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery; D010347:Patient Care Planning; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012535:Scalp / Q000601:surgery; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000637:transplantation; D060053:Transplant Donor Site / Q000601:surgery