INTRODUCTION
As individuals age, morphological and immunological changes affect the skin's function as a protective barrier. These changes not only influence the skin's appearance but also its capacity to heal after injury, including surgical incisions.1
While Mohs Micrographic Surgery provides high cure rates, excising tumors can lead to complex defects necessitating extensive cutaneous repairs, such as linear closures and flaps. With the increasing number of skin cancer patients, particularly those over 65 undergoing Mohs surgery, assessing the outcomes of these large repairs is crucial.2-3
We conducted a retrospective chart review of adult patients presenting at the UCSD Dermatologic and Mohs Micrographic Surgery Center between January 1, 2010, and December 31, 2022. Of these patients, those who underwent dermatologic surgery with linear closures (LCs) greater than or equal to 12.5 cm or flaps greater than or equal to 30 cm2 were included in this study (n=347).
Demographic data, such as age at the time of surgery, was recorded and all cases were categorized into two age groups: 18 to 64 and 65+ years old. Complications and other characteristic data were documented in Table 1. We utilized Tukey’s multiple comparisons test through GraphPad Prism software to compare the mean differences in complication rates among age groups. Statistically significant differences were defined by an adjusted P-value of less than or equal to 0.05.
There was no significant difference in hematoma rates when comparing patients aged 18-64 and 65+ years old for both flaps (P=0.98, 4.7% vs 5.5%) and LC repairs (P=0.98, 5% vs 0%). The same was true when evaluating bleeding complication rates for flaps (P=0.98, 1.9% vs 2.5%) and LC repairs (P=0.98, 10% vs 0%). For LC cases, anticoagulation rates did not significantly vary (P=0.59, 30% vs 42.1%). However, anticoagulation rates were higher in patients aged 65+ who underwent flap repairs (P=0.0005, 25.2% vs 52.2%; Table 1).
While Mohs Micrographic Surgery provides high cure rates, excising tumors can lead to complex defects necessitating extensive cutaneous repairs, such as linear closures and flaps. With the increasing number of skin cancer patients, particularly those over 65 undergoing Mohs surgery, assessing the outcomes of these large repairs is crucial.2-3
We conducted a retrospective chart review of adult patients presenting at the UCSD Dermatologic and Mohs Micrographic Surgery Center between January 1, 2010, and December 31, 2022. Of these patients, those who underwent dermatologic surgery with linear closures (LCs) greater than or equal to 12.5 cm or flaps greater than or equal to 30 cm2 were included in this study (n=347).
Demographic data, such as age at the time of surgery, was recorded and all cases were categorized into two age groups: 18 to 64 and 65+ years old. Complications and other characteristic data were documented in Table 1. We utilized Tukey’s multiple comparisons test through GraphPad Prism software to compare the mean differences in complication rates among age groups. Statistically significant differences were defined by an adjusted P-value of less than or equal to 0.05.
There was no significant difference in hematoma rates when comparing patients aged 18-64 and 65+ years old for both flaps (P=0.98, 4.7% vs 5.5%) and LC repairs (P=0.98, 5% vs 0%). The same was true when evaluating bleeding complication rates for flaps (P=0.98, 1.9% vs 2.5%) and LC repairs (P=0.98, 10% vs 0%). For LC cases, anticoagulation rates did not significantly vary (P=0.59, 30% vs 42.1%). However, anticoagulation rates were higher in patients aged 65+ who underwent flap repairs (P=0.0005, 25.2% vs 52.2%; Table 1).
