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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentations 2 - Facial Plastic and Reconstructive Surgery

Effects of Mohs Facial Reconstruction Timing on Complications and Quality of Life: A Systematic Review

Monday, September 30, 2024
10:18 AM – 10:24 AM EDT
Location: MBCC, 232
Disclosure(s):
Natalia S. Queenan, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jay B. Trivedi, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Neha Garg, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Dev R. Amin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan N. Heffelfinger, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Several factors may affect timing of facial defect reconstruction following Mohs micrographic surgery (MMS) for the treatment of non-melanoma skin cancers (NMSC), including age, comorbidities, and surgical scheduling/logistics. The impact of early ( <24 hours) vs. delayed (>24 hours) reconstruction on complications and quality of life (QoL) is not well established.

Methods: Medline, PubMed, Scopus, and Cochrane databases were systematically searched using keywords relevant to MMS, NMSC, facial reconstruction timing, complications, and QoL. Four independent reviewers screened abstracts; English abstracts with data on repair timing, and complications and/or QoL outcomes were included. Internal and external validity were assessed using USPSTF guidelines and quality assessment was performed using the NIH tool.

Results: Of 4,421 abstracts identified, 13 studies met inclusion criteria for data extraction. All studies evaluated complications and four assessed QoL. Frequently reported complications were infection (6/13), wound dehiscence (6/13), graft necrosis (5/13) and hematoma (5/13). Complication rates were lower in studies evaluating early reconstruction alone (1.27%-3.91%) than those evaluating delayed reconstruction alone (4.5%-18.92%). Five studies compared early vs. delayed reconstruction. One found fewer overall complications for delayed reconstruction (22.9% vs 36.4%). Another found fewer cases of partial graft loss (10.5% vs. 30%), wound contraction (1.5% vs. 26%), and nasal valve impairment (0% vs. 14%) in delayed reconstruction. Three studies found no significant difference between groups. Meta-analysis could not be performed due to limited statistical power, heterogeneity of studies, and risk of bias.

Conclusions: Studies evaluating early reconstruction of Mohs defects alone reported fewer complications than those evaluating delayed reconstruction alone. Mixed data were reported in studies that compared both early and late reconstruction. Future studies to better explore reconstruction timelines are needed.

    Presenting Author(s)

  • Natalia S. Queenan, BA

    Medical Student
    Thomas Jefferson University
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Jay B. Trivedi, BS

    Medical Student
    Sidney Kimmel Medical College
    Philadelphia, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Neha Garg, BA

    Medical Student
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • RT

    Rohith R. Tudi, BS

    MS1
    Thomas Jefferson University
    Philadelphia, PA, United States

    Disclosure information not submitted.

  • AM

    Adam McCann, MD

    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, United States

    Disclosure information not submitted.

  • Dev R. Amin, MD

    Resident Physician
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Ryan N. Heffelfinger, MD

    Professor, Department of OTO-HNS
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.