Comparison of full-thickness skin grafts versus second-intention healing for mohs defects of the helix

Phillip C. Hochwalt, Kevin N. Christensen, Sean R. Cantwell, Thomas L. Hocker, Jerry D. Brewer, Christian L. Baum, Christopher J. Arpey, Clark C. Otley, Randall K. Roenigk

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Two repair options for Mohs defects of the helix include full-thickness skin grafting and second-intention healing. Limited long-term data exist comparing these 2 repair options. Objective: To compare outcomes of full-thickness skin grafts (FTSG) versus second-intention wound healing for Mohs defects on the helix. METHODS: In this study, 29 second-intention and 18 FTSG repairs were evaluated using a visual analog scale (VAS). Patient questionnaires and retrospective chart analysis were used to assess secondary outcomes. Results: The average second-intention VAS score was 82.1 (standard deviation [SD] = 7.6), and the average FTSG VAS score was 75.2 (SD = 16.7) (difference of 6.9, 95% confidence interval:-1.3 to 15.1, p =.061). A subsequent noninferiority test indicated that cosmetic outcome of second-intention healing was at least as good as that of FTSG in the authors' study (p <.001). Retrospective chart analysis revealed no significant difference in complications. Patient-reported outcomes were not significantly different. Conclusion: Mohs surgical defects of the helix left to heal by second-intention have comparable long-term cosmetic outcomes to those repaired by FTSG. There was no significant difference in complications, and patients were highly satisfied with both repair options.

Original languageEnglish (US)
Pages (from-to)69-77
Number of pages9
JournalDermatologic Surgery
Issue number1
StatePublished - Jan 13 2015

ASJC Scopus subject areas

  • Surgery
  • Dermatology


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