Scalp Reconstruction after Mohs Cancer Excision: Lessons Learned from More Than 900 Consecutive Cases
| Autor: | Muhammad Harirah, Kyle Sanniec, Omar Harirah, Tyler Yates, James F. Thornton |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
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 |
| Zdroj: | Plastic and reconstructive surgery. 147(5) |
| ISSN: | 1529-4242 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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