• Ron M Shelton and Ted Chaglassian.
• Department of Dermatology, The Mount Sinai Medical Center, New York, New York, USA. rsheltonmd@aol.com
• Dermatol Surg. 2003 Jun 1; 29 (6): 658-61.

BackgroundLarge defects not otherwise closed primarily may be closed after chronic skin expansion.ObjectiveIf chronic expansion were deemed indicated for the closure of a proposed defect expected to result from Mohs micrographic surgery, can it be performed before Mohs surgery, avoiding the increased chance of expander extrusion via the defect when done postoperatively?MethodsA team approach of a Mohs surgeon and a plastic surgeon coordinated scheduling an insertion of and staged infiltration of a tissue expander before Mohs surgical removal of a large basal cell carcinoma on the back of a young woman. The reconstruction after Mohs surgery was scheduled for the immediate postoperative period.ResultsThe Mohs surgery completed removed the carcinoma, and the expander was removed, enabling the surgeon to perform a side-to-side closure.ConclusionProvided that there is not a great probability of the neoplasm extending significantly deeper or wider than expected and that the skin expander is placed so as not to disturb the plane of Mohs excision, this is a useful technique to close large Mohs defects.

17 keywords...

hide…