Complications and solutions in Mohs micrographic surgery: a retrospective analysis

Resumen

Introduction: Mohs micrographic surgery is the gold standard for non-melanoma skin cancer treatment. It may occasionally present complications. Our objective was to describe the complications we observed in our Dermatologic Surgery Unit and compare our results with other studies.

Materials and methods: we performed a retrospective analysis of all Mohs surgeries done in our service between November 2013 and April 2016. Clinical, tumoral and surgical data were gathered from the patients’ medical history.

Results: 100 individual surgeries in 71 patients were registered; 48 males and 23 females. Mean age was 69.1 ± 1.7 years. Mean defect area was 6.2 ± 0.9 cm². Only 3 complications were seen (3%): flap necrosis, hematoma with flap bulging, and postoperative hemorrhage. All of these occurred in different patients, all of them in active smokers and in the head and neck region.

Discussion: complications are infrequent and are usually surgical site infections, suture dehiscence, bleeding/hematoma or necrosis. Although our number of patients is limited, our results are mostly compatible with the literature. We highlight that active smoking represents a risk factor for complications.

Conclusions: Mohs surgery has a low incidence of complications, and most of these are minor. A knowledge of prevention and treatment modalities is necessary to perform this procedure