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Scalp Reconstruction after Mohs Cancer Excision: Lessons Learned from More Than 900 Consecutive Cases
- Source :
- Plastic and reconstructive surgery. 147(5)
- Publication Year :
- 2021
-
Abstract
- Background Scalp reconstruction has evolved over time. Given the large surface area, location, and high likelihood of sun exposure, the scalp is particularly prone to sun damage and skin cancer. Resection of scalp cancers often leaves a large defect that can be challenging for reconstruction. The authors present objective data and recommendations based on more than 10 years of consecutive scalp reconstructions performed by the senior author (J.F.T.). In addition, the authors describe each method of reconstruction and delineate an algorithm based on the senior author's approach and the cases assessed. Methods The authors conducted a retrospective review of patients who underwent scalp reconstruction after Mohs cancer excision over a 10-year period. Each case was evaluated for key patient characteristics, defect location, defect size, defect composition, reconstructive modality, and complications. Results The senior author (J.F.T.) performed 913 scalp reconstruction procedures. Defects most commonly involved the forehead or vertex of the scalp, with a wide range of sizes. A significant majority of the patients' defects were repaired with the use of adjacent tissue transfer or Integra dermal regeneration templates. There were 94 complications (12.5 percent) noted, ranging from graft loss to cancer recurrence. Conclusions Reconstruction of scalp defects after Mohs cancer excision presents the plastic surgeon with numerous patient and defect preoperative variables to consider. Each defect should be evaluated, and a plan based on composition of the defect and the needs of the patient should be developed. Scalp reconstruction is safe to perform in an outpatient setting, even in elderly patients. Clinical question/level of evidence Therapeutic, IV.
- Subjects :
- Adult
medicine.medical_specialty
Skin Neoplasms
Adolescent
030230 surgery
03 medical and health sciences
Scalp reconstruction
Young Adult
0302 clinical medicine
medicine
Humans
Aged
Retrospective Studies
Aged, 80 and over
Scalp
integumentary system
business.industry
Cancer
Sun damage
Middle Aged
Plastic Surgery Procedures
medicine.disease
Mohs Surgery
body regions
Plastic surgery
medicine.anatomical_structure
Clinical question
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Forehead
Surgery
Radiology
Skin cancer
business
Subjects
Details
- ISSN :
- 15294242
- Volume :
- 147
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Plastic and reconstructive surgery
- Accession number :
- edsair.doi.dedup.....628d27ab68c0224fcddc332626da4472