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Cosmetic and Functional Outcomes of Second Intention Healing for Mohs Defects of the Lips

Donigan, Jessica M. MD; Millican, Eric A. MD*

doi: 10.1097/DSS.0000000000001611
Original Article

BACKGROUND The lips are a common location for skin cancer and thus for Mohs micrographic surgery (MMS). There are few studies looking at second intention healing of Mohs defects of the lips, and none have used a scar assessment scale.

OBJECTIVE To evaluate the acceptability of second intention healing of the vermilion lips following MMS using a patient questionnaire and the Patient and Observer Assessment Scale (POSAS).

METHODS Eligible patients were found through chart review. A patient questionnaire and the patient scale of the POSAS were performed over the phone. For patients who were able to come to clinic, the observer scale of the POSAS was performed.

RESULTS Forty-seven phone interviews and 21 clinic assessments were performed. Overall, patients noted excellent functional outcomes, and good to excellent cosmetic outcomes, and were satisfied with healing time. There was not a significant difference between the patient and observer total scores (p = .63) or overall scores (p = .59).

CONCLUSION Second intention healing can have satisfactory functional and cosmetic outcomes and healing times with few complications and should be considered for surgical defects on the vermilion lips as large as 2.8 cm2 even when there is involvement of the cutaneous lip and muscular layer.

*Both authors are affiliated with the Department of Dermatology, University of Utah, Salt Lake City, Utah

Address correspondence and reprint requests to: Jessica M. Donigan, MD, Dermatology Resident, 30 North 1900 East, 4A330 School of Medicine, Salt Lake City, UT 84132, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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