Kohli Nita, Kwedar Kathleen, Golda Nicholas
University of Missouri-Columbia, Department of Dermatology, Columbia, Missouri.
Dermatol Online J. 2017 May 15;23(5):13030/qt6dx2m7cf.
It is common for dermatology surgery patients to present on the day of surgery with more than one skin cancer needing Mohs micrographic surgery. When these carcinomas are located near one another, it may be more practical to treat both at the same time as the reconstruction for one defect may involve or otherwise affect the treatment or reconstruction for the other carcinoma. Treating both cancers on the same day creates an opportunity for efficient repairs where a creative single reconstruction may minimize the amount of tissue wasted during reconstruction,and minimize morbidity for the patient. Further,combining multiple defects into one closure may reduce cost as it has been shown that reconstructive choice affects the cost-effectiveness of Mohs surgery relative to a traditional excision and Mohs surgeons more commonly select less costly options for wound management. We present a case series of two-in-one closures - repairing two defects with one closure.
皮肤科手术患者在手术当天出现不止一种需要进行莫氏显微外科手术的皮肤癌是很常见的。当这些癌灶彼此相邻时，同时治疗两者可能更实际，因为一个缺损的重建可能会涉及或影响另一个癌灶的治疗或重建。同一天治疗两种癌症为高效修复创造了机会，创造性的单一重建可以最大限度地减少重建过程中浪费的组织量，并将患者的发病率降至最低。此外，将多个缺损合并为一次缝合可能会降低成本，因为已经表明，重建选择会影响莫氏手术相对于传统切除术的成本效益，并且莫氏外科医生更常选择成本较低的伤口处理方案。我们展示了一系列二合一缝合的病例——用一次缝合修复两个缺损。
