Efficacy and complication rates of full-thickness skin graft repair of lower extremity wounds after Mohs micrographic surgery.

BACKGROUND: Repair of below-the-knee lower extremity defects after Mohs micrographic surgery (MMS) that are not amenable to primary closure can be challenging given the high propensity for complications. No criterion standard exists for management of these wounds, but secondary-intention healing, partial- and full-thickness skin grafts (FTSGs), and various flaps are possible options to manage these wounds. Few data exist on the efficacy of FTSG repairs for lower extremity wounds.

OBJECTIVES: Assess the efficacy and complications rates of FTSG repairs for lower extremity wounds after MMS.

METHODS: This was a retrospective review of 80 FTSG repairs performed after MMS. Data were derived from 45 cases at Beth Israel Deaconess Medical Center and 35 cases at University of California, San Diego (UCSD) Medical Center.

RESULTS: Seventy-two of 80 cases (90%) had full graft survival, six (7.5%) had partial failure, and two (2.5%) had complete failure. In the cases where grafts had failed, wounds healed by secondary intention without further complications. Other complications included infections in nine (11%) cases and hematoma formation in two (2.5%).

CONCLUSION: FTSG is a consistent and safe reconstructive option for the management of lower extremity wounds after MMS.