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Delayed Mohs surgery does not impact complication risk

The timing of Mohs micrographic reconstructive surgery had no impact on infection risk or flap failure, according to recent findings.

The researchers suggested that while a delay to reconstructive surgery time may allow for planning and blood flow to the wound bed, some evidence has suggested that a delay of more than 2 days may increase complications in the post-operative setting.

The current study included retrospective data from 633 defects in 591 patients who underwent the procedures between January 2012 and March 2017. One of two clinicians performed all surgeries at a single institution.

Outcome measures included hematoma, infection, dehiscence, and partial or full graft or flap loss.

The range of time between reconstruction was less than 24 hours to 32 days after Mohs surgery, with 229 reconstructions (36.2%) occurring more than 48 hours after surgery.

Multivariate analysis results revealed a number of factors that elevated post-operative complication risk, including smoking status (OR = 2.46; P = .007), defect size (OR = 1.04; P = .006), full-thickness defects (OR = 1.56; P = .02), interpolated flaps with cartilage grafting (OR = 8.09; P < .001), and composite grafts (OR = 6.35; P < .001).

The researchers assessed the cohort for patient-specific variables including comorbidities, age, smoking status, and anticoagulant or antiplatelet use status. In addition to the duration between Mohs surgery and reconstruction, they also evaluated surgery-specific variables such as the location and size of the defect and the mode of reconstruction.

“We found no association between timing of Mohs reconstructive surgery and complications, indicating that a delayed repair did not increase the risk of infection or flap failure,” the researchers concluded. – by Rob Volansky

Disclosures: The authors report no relevant financial disclosures.