title: Comparison of full-thickness skin grafts versus second-intention healing for Mohs defects of the helix.
abstract: BACKGROUND
  Two repair options for Mohs defects of the helix include full-thickness skin grafting and second-intention healing. Limited long-term data exist comparing these 2 repair options.
  
  
  OBJECTIVE
  To compare outcomes of full-thickness skin grafts (FTSG) versus second-intention wound healing for Mohs defects on the helix.
  
  
  METHODS
  In this study, 29 second-intention and 18 FTSG repairs were evaluated using a visual analog scale (VAS). Patient questionnaires and retrospective chart analysis were used to assess secondary outcomes.
  
  
  RESULTS
  The average second-intention VAS score was 82.1 (standard deviation [SD] = 7.6), and the average FTSG VAS score was 75.2 (SD = 16.7) (difference of 6.9, 95% confidence interval: -1.3 to 15.1, p = .061). A subsequent noninferiority test indicated that cosmetic outcome of second-intention healing was at least as good as that of FTSG in the authors' study (p < .001). Retrospective chart analysis revealed no significant difference in complications. Patient-reported outcomes were not significantly different.
  
  
  CONCLUSIONS
  Mohs surgical defects of the helix left to heal by second-intention have comparable long-term cosmetic outcomes to those repaired by FTSG. There was no significant difference in complications, and patients were highly satisfied with both repair options.
authors.affiliation: *Department of Dermatology, Mayo Clinic, Rochester, Minnesota; †Mayo Medical School, Mayo Clinic, Rochester, Minnesota.
authors.forename: Phillip C
authors.initials: PC
authors.lastname: Hochwalt
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Christensen
authors.forename: Sean R
authors.initials: SR
authors.lastname: Cantwell
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Hocker
authors.forename: Jerry D
authors.initials: JD
authors.lastname: Brewer
authors.forename: Christian L
authors.initials: CL
authors.lastname: Baum
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Arpey
authors.forename: Clark C
authors.initials: CC
authors.lastname: Otley
authors.forename: Randall K
authors.initials: RK
authors.lastname: Roenigk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054644:Ear Auricle; D004428:Ear Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000009:adverse effects*; D010149:Postoperative Pain / Q000209:etiology; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation / Q000009:adverse effects; D014945:Wound Healing