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Safety of Staged Interpolation Flaps After Mohs Micrographic Surgery in an Outpatient Setting: A Single-Center Experience

Newlove, Tracey, MD1; Cook, Joel, MD1

doi: 10.1111/dsu.12338

OBJECTIVE To establish the safety of staged interpolation flaps performed in an outpatient dermatologic clinic setting.

METHODS A retrospective chart review was performed of patients who underwent staged interpolation flap reconstruction by a single dermatologic surgeon after tumor clearance using Mohs micrographic surgery from 2000 to 2012 at the Department of Dermatology, Medical University of South Carolina.

RESULTS Six hundred fifty-three staged flaps were performed in 639 patients (mean age 65) between June 2000 and November 2012. Types of flaps included paramedian forehead flaps (n = 291, 45%), two-stage melolabial flaps (n = 256, 39%), retroauricular flaps (n = 58, 9%), interpolated paranasal flaps (n = 40, 6%), and Abbe or Abbe-Estlander flaps (n = 8, 1%). No major complications were observed. Of the minor complications, problems related to bleeding were the most prevalent; active bleeding requiring physician intervention was seen in 8.4% and hematoma formation in 0.4% of flaps. Postoperative infections were seen in 1.7% of patients after the initial surgery and 3.4% after division of the pedicle. Primary or secondary dehiscence was seen in 0.5%. Partial full-thickness flap necrosis was seen in 2.3% and total flap necrosis in 0.6%.

CONCLUSION The rate of complications associated with dermatologic surgeons performing interpolated flaps in an outpatient setting under local anesthesia is low. Our complication rates are equal to or lower than published complication rates from other surgical specialties.

1Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina,

Address correspondence and reprint requests to: Joel Cook, MD, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Suite 1101, Charleston, South Carolina 29403, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2013 by the American Society for Dermatologic Surgery, Inc.
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