Prevalence of wound complications following Mohs micrographic surgery (MMS): a cross-sectional study of 1000 patients undergoing MMS and wound repair in a UK teaching hospital.

Autor: Rutkowski D; Department of Dermatology, Northern Care Alliance NHS Foundation Trust, Manchester, UK.; Centre for Dermatology Research, The University of Manchester, Manchester, UK., Littlewood Z; Department of Dermatology, Northern Care Alliance NHS Foundation Trust, Manchester, UK., Touyz SJJ; Department of Dermatology, Northern Care Alliance NHS Foundation Trust, Manchester, UK., Collier NJ; Department of Dermatology, Northern Care Alliance NHS Foundation Trust, Manchester, UK., Madan V; Department of Dermatology, Northern Care Alliance NHS Foundation Trust, Manchester, UK., Ghura HS; Department of Dermatology, Northern Care Alliance NHS Foundation Trust, Manchester, UK., Yiu ZZN; Department of Dermatology, Northern Care Alliance NHS Foundation Trust, Manchester, UK.; Centre for Dermatology Research, The University of Manchester, Manchester, UK., Telfer N; Department of Dermatology, Northern Care Alliance NHS Foundation Trust, Manchester, UK.
Jazyk: angličtina
Zdroj: Clinical and experimental dermatology [Clin Exp Dermatol] 2022 Aug; Vol. 47 (8), pp. 1536-1542. Date of Electronic Publication: 2022 May 25.
DOI: 10.1111/ced.15226
Abstrakt: Background: Mohs micrographic surgery (MMS) for nonmelanoma skin cancer is often quoted as having an excellent safety profile.
Aim: To determine the complication rate of patients undergoing MMS in a large UK Mohs unit and subdivide complication rates into mild/intermediate and major, and to identify potential risk factors necessitating a clinical intervention.
Methods: This was a single-centre, cross-sectional study of 1000 consecutive cases of MMS performed with in-house repair. Notes from the postsurgical dressing clinics were reviewed at Visit 1 (Days 7-14) and Visit 2 (approximately Week 6). Based upon the intervention required and effect on cosmetic/functional outcome, complications were classified as minor, intermediate or major. Logistic regression modelling was used to identify risk factors associated with a complication that needed a clinical intervention (i.e. intermediate or major).
Results: In total, 1000 Mohs surgeries were performed on 803 patients, resulting in 1067 excisions. Complication rates in our cohort were low (minor 3.6%, intermediate 3.1% and major 0.8%) Potential risk factors for developing a complication included skin graft (unadjusted OR = 4.89, 95% CI 1.93-12.39; fully adjusted OR = 7.13, 95% CI 2.26-22.45) and patients undergoing surgery on the forehead (unadjusted OR = 3.32, 95% CI 0.95-11.58; fully adjusted OR = 5.34, 95% CI 1.40-20.42). Patients whose wounds were allowed to heal by secondary intention healing (6.8%) exhibited no complications.
Conclusion: We advocate that patients should be informed during the consent procedure that less than 1 in every 100 patients (0.75%) undergoing MMS will have a serious adverse event (major complication) affecting their cosmetic or functional outcome.
(© 2022 The Authors. Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.)
Databáze: MEDLINE
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