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鼻部莫氏手术缺损的插入皮瓣修复术后并发症:一项多中心前瞻性队列研究

Postoperative Complications After Interpolated Flap Repair for Mohs Defects of the Nose: A Multicenter Prospective Cohort Study.

作者信息

Perz Allison M, Lukowiak Tess M, Lee Michael P, Neal Donald, Aizman Leora, Miller Christopher J, Golda Nicholas, Albertini John G, Holmes Todd, Bar Anna, Leitenberger Justin, Maher Ian, Sobanko Joseph F, Chen David, Hollmig Tyler, Aasi Sumaira, Sutton Adam, Higgins H William, Shin Thuzar M, Weinberger Christine, Mattox Adam, Wysong Ashley, Etzkorn Jeremy R

机构信息

Cooper Medical School of Rowan University, Camden, New Jersey.

Drexel University College of Medicine, Philadelphia, Pennsylvania.

出版信息

Dermatol Surg. 2023 Feb 1;49(2):135-139. doi: 10.1097/DSS.0000000000003653. Epub 2022 Dec 22.

Abstract

BACKGROUND

Dermatologists perform most interpolated flaps after skin cancer resection. Prospective, multicenter data on complications after interpolated flap repair in this setting are limited.

OBJECTIVE

To determine the rate of physician-reported complications after interpolated flap repair of the nose.

METHODS

Multicenter, prospective cohort study of 169 patients undergoing 2-stage interpolated flap repair of post-Mohs nasal defects. Frequency of bleeding, infection, dehiscence, necrosis, hospitalization, and death in the 30 days after flap placement and flap takedown are reported.

RESULTS

Patients experienced 23 complications after flap placement (13.61%) and 6 complications after flap takedown (3.55%) that were related to the surgical procedure. The most frequent complication after flap placement was bleeding (9, 5.33%, 95% confidence interval [CI]: 2.83%-9.82%). The most frequent complication after flap takedown was infection (5, 2.96%, 95% CI: 1.27%-6.74%). There was one hospitalization related to an adverse reaction to antibiotics. There were no deaths.

CONCLUSION

Most complications after interpolated flap repair for post-Mohs defects of the nose are minor and are associated with flap placement. Interpolated flap repair for post-Mohs defects can be performed safely in the outpatient setting under local anesthesia.

摘要

背景

皮肤科医生在皮肤癌切除术后进行大多数的插入皮瓣手术。在此情况下,关于插入皮瓣修复术后并发症的前瞻性多中心数据有限。

目的

确定鼻部插入皮瓣修复术后医生报告的并发症发生率。

方法

对169例行Mohs术后鼻缺损二期插入皮瓣修复术的患者进行多中心前瞻性队列研究。报告皮瓣植入和皮瓣拆除后30天内出血、感染、裂开、坏死、住院和死亡的发生频率。

结果

患者在皮瓣植入后出现23例并发症(13.61%),在皮瓣拆除后出现6例并发症(3.55%),均与手术操作有关。皮瓣植入后最常见的并发症是出血(9例,5.33%,95%置信区间[CI]:2.83%-9.82%)。皮瓣拆除后最常见的并发症是感染(5例,2.96%,95%CI:1.27%-6.74%)。有1例住院与抗生素不良反应有关。无死亡病例。

结论

Mohs术后鼻部缺损插入皮瓣修复术后的大多数并发症较轻微,且与皮瓣植入有关。Mohs术后缺损的插入皮瓣修复可在门诊局部麻醉下安全进行。

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