Clinical Outcome of Cutaneous Flaps Versus Full-Thickness Skin Grafts After Mohs Surgery on the Nose

BACKGROUND A large proportion of facial skin cancers occur on the nose, and defects after Mohs surgery in this location often present a reconstructive challenge. For intermediate-sized defects, the choice of reconstruction is usually between skin flap and full-thickness skin graft. Ongoing debate exists, and limited data are available to determine which of these methods is more satisfactory. OBJECTIVE To evaluate and compare the clinical appearance of wound healing after surgical repair with a skin graft versus a skin flap for Mohs defects on the nose. METHOD In this study, 43 flaps and 24 grafts were evaluated using a modified Hollander Wound Evaluation Scale and a visual analogue scale. RESULTS The mean visual analogue scale score was significantly better for flap repairs than for graft repairs. In addition, 100% of flaps had an acceptable overall cosmetic appearance on the basis of the Hollander Wound Evaluation Scale, compared with only 75% of skin grafts. CONCLUSIONS For defects on the nose where flap and graft repair may both be technically possible, a flap may be more likely to result in superior cosmetic outcome. The authors have indicated no significant interest with commercial supporters.