Secondary Intention Healing After MOHS - 39 years (Photo)

Question

I had MOHS performed to remove BCC. The dermatologist surgeon advised to wait and let the wound heal by secondary intention. She mentioned that trying to close it immediately would have resulted in big scars. In the surgeon’s view this would still allow me to have reconstructive surgery later with a plastic surgeon and it might lead to a better cosmetic result. Any views on this approach? What type of reconstructive technique could be used? Thanks a lot

John Louis Ratz, MD · Answer

Your Mohs surgeon made a wise decision. Second intention healing will have two benefits for you. The first of these is that the wound will contract during the healing process and new skin (epidermis) will cover the defect, growing from the outside into the center. The result will be a healed area usually about 30% the size of the original defect. This healed area should be flat and pink at first, but will lighten with time. And, yes, it could be white. It could also be raised or depressed. BUT. . . it is now one third the size of the original defect. Giving the area a chance to reach complete healing, which is usually about 6 months, the area can then be repaired in a much simpler and safer fashion at less cost. This delayed repair is also usually covered by your insurance, as well.                    jlr

Timothy W. Chang, MD, FAAD · Answer

The wound appears to be very shallow. Secondary intention is an option and may heal well, but with a slight depression and white scar tissue.  A flap could be performed, but would need to be taken from the glabella or the forehead.  Another option is placing skin graft, which would correct the depression but will likely be slightly off color.

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Secondary Intention Healing After MOHS - 39 years (Photo)

Answers (2)

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