Timing of Mohs Reconstructive Surgery Not Associated With Postoperative Complications

Mohs procedure
Mohs procedure
The findings may influence Mohs surgical counseling and help resolve scheduling issues.

No association has been observed between the timing of Mohs micrographic surgery (MMS) reconstruction and the development of complications, according to results published in JAMA Facial Plastic Surgery.

Investigators sought to review outcomes of MMS reconstruction with regard to patient-specific and surgery-specific variables, in particular timing of the repair. The study included 591 patients (median age, 65 [21 to 96]; 56.3% women.) A total of 633 defects were identified over the 5-year study period.

Reconstructions were performed from <24 hours to 32 days following MMS, with 36.2% of the procedures delayed for >48 hours. Included among patient-specific variables were comorbidities, age, smoking status, and use of anticoagulant/antiplatelet medications. Surgery-specific variables included location and size of the defect, timing between MMS and reconstruction, and type of reconstructive modality. Single-variable analysis was used to establish whether each of the variables was associated with postoperative complications.

After multivariate analysis, smoking status (odd ratio [OR] 2.46; 95% CI, 1.29-4.71; P =.007), defect size (OR 1.04; 95% CI, 1.01-1.06; P =.006), full-thickness defects (OR 1.56; 95% CI, 1.08-2.25; P =.02), interpolated flaps with cartilage grafting (OR 8.09; 95% CI, 2.65-24.73; P <.001), and composite grafts (OR 6.35; 95% CI, 2.25-17.92; P <.001) were all associated with an increased risk for postoperative complications.

No significant association was observed between the timing of MMS reconstruction and complications, indicating that delayed repair did not increase an individual’s risk for infection or flap failure.

“This information allows surgeons to plan reconstruction so that it facilitates surgical planning, patient counseling, and scheduling issues,” the investigators concluded.

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Miller MQ, David AP, McLean JE, Park SS, Christophel J. Association of Mohs reconstructive surgery timing with postoperative complications [published online September 7, 2017]. JAMA Facial Plast Surg. doi:10.1001/jamafacial.2017.1154