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Skin substitutes for the management of mohs micrographic surgery wounds: a systematic review

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Abstract

The data on skin substitute usage for managing Mohs micrographic surgery (MMS) wounds remain limited. This systematic review aimed to provide an overview of skin substitutes employed for MMS reconstruction, summarize clinical characteristics of patients undergoing skin substitute-based repair after MMS, and identify advantages and limitations of skin substitute implementation. A systematic review of Ovid MEDLINE, EMBASE, Cochrane Library, and Web of Science databases, from inception to April 7, 2021, identified all cases of MMS defects repaired using skin substitutes. A total of 687 patients were included. The mean patient age was 70 years (range: 6–98 years). Commonly used skin substitutes were porcine collagen (n = 397), bovine collagen (n = 78), Integra (n = 53), Hyalofill (n = 43), amnion/chorion-derived grafts (n = 40), and allogeneic epidermal-dermal composite grafts (n = 35). Common factors influencing skin substitute selection were cost, healing efficacy, cosmetic outcome, patient comfort, and ease of use. Some articles did not specify patient and wound characteristics. Skin substitute usage in MMS reconstruction is not well-guided. Blinded randomized control trials comparing the efficacy of skin substitutes and traditional repair methods are imperative for establishing evidence-based guidelines on skin substitute usage following MMS.

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  1. Renaissance School of Medicine, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA

    Kimberly W. Lu

  2. Veterans Affairs Medical Center, Brooklyn, NY, USA

    Amor Khachemoune

  3. Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA

    Amor Khachemoune

  4. Veterans Affairs Hospital and SUNY Downstate Dermatology Service, 800 Poly Place, Brooklyn, NY, 11209, USA

    Amor Khachemoune

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Amor Khachemoune, MD, FAAD, FACMS, provided the idea for the article. Kimberly W. Lu, BS, performed the initial literature search. Both authors independently screened retrieved articles. Kimberly W. Lu, BS, conducted the data analysis, wrote the initial draft, and prepared figures and tables for the manuscript. Amor Khachemoune, MD, FAAD, FACMS, revised the work.

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Lu, K.W., Khachemoune, A. Skin substitutes for the management of mohs micrographic surgery wounds: a systematic review. Arch Dermatol Res 315, 17–31 (2023). https://doi.org/10.1007/s00403-022-02327-1

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  • DOI: https://doi.org/10.1007/s00403-022-02327-1

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