xRead - Facial Reconstruction Following Mohs Micrographic Surgery

Archives of Dermatological Research (2023) 315:1853–1861

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Among all articles combined, the reconstructive tech niques were reported for 3678 repairs. Types of reported reconstructive techniques for all periorbital zones are shown in Fig. 3. Local skin flaps (39%) were the most commonly reported reconstructive method followed by skin grafts (23%) and linear repairs (18%). Thirty-three of 53 articles specified which reconstructive techniques were used in which periorbital subunit (i.e., upper eyelid, lower eyelid, medial canthus, lateral canthus). Other articles listed the

reconstructive techniques used but did not link the recon structive techniques with a specific periorbital subunit. Data for reconstructive techniques by zone is shown in Table 1. Local skin flaps, skin grafts, and tarsoconjunctival flaps were the most reported techniques for lower eyelid defects. Reconstruction of upper eyelid defects most often involved skin grafts, local skin flaps, and linear closures. For medial canthus defects, the most reported reconstructive methods were skin grafts, local skin flaps, and secondary intention healing. Insufficient data was available for the reconstructive techniques employed for defects of the lateral canthus (only 3 articles with a total of 7 repairs). We also examined the frequency of reconstructive tech niques between specialties. Articles with the first and last authors being ophthalmologists were the only articles to publish on the use of tarsoconjunctival grafts. Use of skin grafts were more commonly reported in articles published by ophthalmologists (39% of total repairs reported in articles by ophthalmologists) compared to dermatologists (17% of total repairs reported in articles by dermatologists). Conversely local skin flaps were more commonly reported in articles published by dermatologists (62%) compared to ophthalmol ogists (25%). The percentage of reported cases with second ary intention healing was similar across specialties, 4% for dermatology, 1% for ophthalmology, and 1% for PRS. There were only a few articles published by otolaryngologists in this systematic review so meaningful comparisons between otolaryngologists and other specialties could not be made.

Fig. 2 Anatomic locations of the tumors or defects ( n = 4408) in all cases with available data. Tumors or defects that spanned 2 or more zones were categorized as “multiple zones”

Fig. 3 Types of reconstruc tive methods employed for all cases in any periorbital zone with available data ( n = 3678). If multiple techniques were employed for reconstruction of the same defect in the same patient, these techniques were counted separately

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