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Application of secondary intention for the restoration of the apical triangle after Mohs micrographic surgery

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Abstract Background Restoring the apical triangle (AT) to maintain the symmetry of the face after Mohs micrographic surgery can be challenging. We have applied secondary intention (SI) after partial closure… Click to show full abstract

Abstract Background Restoring the apical triangle (AT) to maintain the symmetry of the face after Mohs micrographic surgery can be challenging. We have applied secondary intention (SI) after partial closure in cases with large defects. Objective To compare the cosmetic results between immediate closure (IC) and SI. Methods & Materials We retrospectively reviewed 24 patients (IC group: n = 15, SI group: n = 9). To evaluate the symmetry, the comparative ratio (CR; area of the AT of the involved side/area of the normal contralateral side) was calculated. Results The defects were significantly larger in the SI group than in the IC group (588.89 ± 346.53 mm2 vs. 252.87 ± 196.52 mm2, p < .01). While there was no statistically significant difference in average CR, the standard deviation was higher in the SI group (0.95 ± 0.08 vs. 0.93 ± 0.31, p = .3359), indicating the difficulty in predicting the results of SI healing. The average visual analog scale score evaluated by two dermatologists was higher in the IC group, albeit without a significant difference (8.23 ± 0.96 vs. 7.78 ± 1.52, p = .5267). Conclusion SI after partial closure can be an option for large defects in the AT area.

Keywords: apical triangle; group; secondary intention; mohs micrographic; micrographic surgery

Journal Title: Journal of Dermatological Treatment
Year Published: 2019

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