BACKGROUND: Second-intention healing over exposed bone is considered by some to be subject to the complications of pain, infection, and nonhealing. OBJECTIVE: Our purpose was to determine would healing by second intention over exposed scalp or facial bone after Mohs micrographic surgery for skin cancer. METHODS: The chart records of all patients treated between 1981 and 1992 for skin cancer that resulted in exposed bone were identified. RESULTS: There were 115 wounds in 91 patients that were managed by second-intention healing, or partial closure, or both. Three cases of soft tissue infection occurred adjacent to nasal and sinus areas. The overall complication rate was 5.4% (6 of 112 cases) and consisted of localized soft tissue infections (2.7%) and poor wound healing (2.7%). There were no cases of osteomyelitis. Second-intention wound healing was successful in 95% of the wounds. CONCLUSION: The outpatient management of exposed bone after Mohs surgery is relatively safe. Relative risk factors for development of complications include (1) a history of previous x-radiation treatment for skin cancer, (2) manipulation of the operative site, and (3) an open defect located near the nose or exposed sinus cavity.
BACKGROUND: Second-intention healing over exposed bone is considered by some to be subject to the complications of pain, infection, and nonhealing. OBJECTIVE: Our purpose was to determine would healing by second intention over exposed scalp or facial bone after Mohs micrographic surgery for skin cancer. METHODS: The chart records of all patients treated between 1981 and 1992 for skin cancer that resulted in exposed bone were identified. RESULTS: There were 115 wounds in 91 patients that were managed by second-intention healing, or partial closure, or both. Three cases of soft tissue infection occurred adjacent to nasal and sinus areas. The overall complication rate was 5.4% (6 of 112 cases) and consisted of localized soft tissue infections (2.7%) and poor wound healing (2.7%). There were no cases of osteomyelitis. Second-intention wound healing was successful in 95% of the wounds. CONCLUSION: The outpatient management of exposed bone after Mohs surgery is relatively safe. Relative risk factors for development of complications include (1) a history of previous x-radiation treatment for skin cancer, (2) manipulation of the operative site, and (3) an open defect located near the nose or exposed sinus cavity.
Authors: Pinkal Patel; James Edward Massey Young; Mark McRae; Jenny Santos; Carolyn Levis; Michael K Gupta; Sophocles Voineskos; Lucas Gallo; Emily Dunn; Matthew C McRae Journal: Cureus Date: 2020-06-21