TY - JOUR
T1 - Comparison of full-thickness skin grafts versus second-intention healing for mohs defects of the helix
AU - Hochwalt, Phillip C.
AU - Christensen, Kevin N.
AU - Cantwell, Sean R.
AU - Hocker, Thomas L.
AU - Brewer, Jerry D.
AU - Baum, Christian L.
AU - Arpey, Christopher J.
AU - Otley, Clark C.
AU - Roenigk, Randall K.
N1 - Publisher Copyright:
© 2014 by the American Society for Dermatologic Surgery, Inc. Published by Lippincott Williams & Wilkins.
PY - 2015/1/13
Y1 - 2015/1/13
N2 - 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. Conclusion: 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.
AB - 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. Conclusion: 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.
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U2 - 10.1097/DSS.0000000000000208
DO - 10.1097/DSS.0000000000000208
M3 - Article
C2 - 25545178
AN - SCOPUS:84920830036
SN - 1076-0512
VL - 41
SP - 69
EP - 77
JO - Dermatologic Surgery
JF - Dermatologic Surgery
IS - 1
ER -