Outcome analysis of Mohs surgery of the lip and chin: comparing secondary intention healing and surgery.

Wounds of the lip and chin resulting from microscopically controlled (Mohs) surgery are often repaired immediately. However, wounds allowed to heal by secondary intention have the advantage of optimal cancer surveillance, simplified wound care, and avoidance of the costs and potential complications associated with reconstructive procedures. Accurate prediction of the course of wound healing would allow a rational approach to selection of surgery or healing by secondary intention. The authors evaluated 105 patients with defects of the lip and chin after Mohs excision for cancer who healed by secondary intention. Forty-six patients treated surgically were followed for comparison. The lip and chin were divided into subunits and the wound location, size, and depth were recorded. Patients were followed at intervals and a final determination regarding cosmesis was made after 6 or more months. It is concluded that the final cosmetic result can be confidently predicted on the basis of location by subunit, size, and depth of the wound.