Complications After Mohs Micrographic Surgery in Patients Aged 85 and Older
BACKGROUNDAs the US population ages, safe surgical procedures are necessary for treatment of cutaneous neoplasms in very elderly patients. OBJECTIVETo determine the incidence of complications associated with Mohs micrographic surgery (MMS) in patients aged 85 and older, and the risk factors that pre...
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| Veröffentlicht in: | Dermatologic surgery 2021-02, Vol.47 (2), p.189-193 |
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| creator | Nemer, Kathleen M. Ko, James J. Hurst, Eva A. |
| description | BACKGROUNDAs the US population ages, safe surgical procedures are necessary for treatment of cutaneous neoplasms in very elderly patients.
OBJECTIVETo determine the incidence of complications associated with Mohs micrographic surgery (MMS) in patients aged 85 and older, and the risk factors that predispose to complications.
METHODSA 9-year retrospective chart review of patients aged 85 and older who underwent MMS at our institution between 07/2007 and 11/2016 was performed. Six types of complications associated with scalpel-based cutaneous surgery were recorded, as well as patient, tumor, and repair characteristics.
RESULTSThis study included 949 patients totaling in 1683 MMS cases. There were 30 complicationsinfection (N = 11), wound dehiscence (N = 6), hematoma (N = 6), hemorrhage (N = 5), flap necrosis (N = 1), and graft necrosis (N = 1), resulting in an overall complication rate of 1.78%. Independent risk factors associated with a statistically higher incidence of complications were anticoagulant use (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.26–6.13; p = .012), extremity location (OR, 2.80; 95% CI, 1.19–6.54; p = .018), greater than 2 MMS stages (OR, 2.43; 95% CI, 1.08–5.46; p = .032), and flap repair (OR, 2.27; 95% CI, 1.05–4.90; p = .036).
CONCLUSIONMohs micrographic surgery is a safe procedure for treatment of cutaneous neoplasms in the very elderly. |
| doi_str_mv | 10.1097/DSS.0000000000002452 |
| format | Article |
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OBJECTIVETo determine the incidence of complications associated with Mohs micrographic surgery (MMS) in patients aged 85 and older, and the risk factors that predispose to complications.
METHODSA 9-year retrospective chart review of patients aged 85 and older who underwent MMS at our institution between 07/2007 and 11/2016 was performed. Six types of complications associated with scalpel-based cutaneous surgery were recorded, as well as patient, tumor, and repair characteristics.
RESULTSThis study included 949 patients totaling in 1683 MMS cases. There were 30 complicationsinfection (N = 11), wound dehiscence (N = 6), hematoma (N = 6), hemorrhage (N = 5), flap necrosis (N = 1), and graft necrosis (N = 1), resulting in an overall complication rate of 1.78%. Independent risk factors associated with a statistically higher incidence of complications were anticoagulant use (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.26–6.13; p = .012), extremity location (OR, 2.80; 95% CI, 1.19–6.54; p = .018), greater than 2 MMS stages (OR, 2.43; 95% CI, 1.08–5.46; p = .032), and flap repair (OR, 2.27; 95% CI, 1.05–4.90; p = .036).
CONCLUSIONMohs micrographic surgery is a safe procedure for treatment of cutaneous neoplasms in the very elderly.</description><identifier>ISSN: 1076-0512</identifier><identifier>EISSN: 1524-4725</identifier><identifier>DOI: 10.1097/DSS.0000000000002452</identifier><identifier>PMID: 32796326</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Age Factors ; Aged, 80 and over ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Extremities ; Female ; Humans ; Incidence ; Male ; Mohs Surgery - adverse effects ; Neoplasm Staging ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Retrospective Studies ; Risk Factors ; Skin - pathology ; Skin Neoplasms - diagnosis ; Skin Neoplasms - pathology ; Skin Neoplasms - surgery ; Surgical Flaps - adverse effects ; Surgical Flaps - transplantation</subject><ispartof>Dermatologic surgery, 2021-02, Vol.47 (2), p.189-193</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>2020 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2020 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4012-e0359cf623c5c0a3bc09b376d7bac8941c183c6609272b7be4c0969eca67774b3</citedby><cites>FETCH-LOGICAL-c4012-e0359cf623c5c0a3bc09b376d7bac8941c183c6609272b7be4c0969eca67774b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32796326$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nemer, Kathleen M.</creatorcontrib><creatorcontrib>Ko, James J.</creatorcontrib><creatorcontrib>Hurst, Eva A.</creatorcontrib><title>Complications After Mohs Micrographic Surgery in Patients Aged 85 and Older</title><title>Dermatologic surgery</title><addtitle>Dermatol Surg</addtitle><description>BACKGROUNDAs the US population ages, safe surgical procedures are necessary for treatment of cutaneous neoplasms in very elderly patients.
OBJECTIVETo determine the incidence of complications associated with Mohs micrographic surgery (MMS) in patients aged 85 and older, and the risk factors that predispose to complications.
METHODSA 9-year retrospective chart review of patients aged 85 and older who underwent MMS at our institution between 07/2007 and 11/2016 was performed. Six types of complications associated with scalpel-based cutaneous surgery were recorded, as well as patient, tumor, and repair characteristics.
RESULTSThis study included 949 patients totaling in 1683 MMS cases. There were 30 complicationsinfection (N = 11), wound dehiscence (N = 6), hematoma (N = 6), hemorrhage (N = 5), flap necrosis (N = 1), and graft necrosis (N = 1), resulting in an overall complication rate of 1.78%. Independent risk factors associated with a statistically higher incidence of complications were anticoagulant use (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.26–6.13; p = .012), extremity location (OR, 2.80; 95% CI, 1.19–6.54; p = .018), greater than 2 MMS stages (OR, 2.43; 95% CI, 1.08–5.46; p = .032), and flap repair (OR, 2.27; 95% CI, 1.05–4.90; p = .036).
CONCLUSIONMohs micrographic surgery is a safe procedure for treatment of cutaneous neoplasms in the very elderly.</description><subject>Age Factors</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - administration & dosage</subject><subject>Anticoagulants - adverse effects</subject><subject>Extremities</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Mohs Surgery - adverse effects</subject><subject>Neoplasm Staging</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Skin - pathology</subject><subject>Skin Neoplasms - diagnosis</subject><subject>Skin Neoplasms - pathology</subject><subject>Skin Neoplasms - surgery</subject><subject>Surgical Flaps - adverse effects</subject><subject>Surgical Flaps - transplantation</subject><issn>1076-0512</issn><issn>1524-4725</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkF1LwzAUhoMobk7_gUj-QOfJR5PmcsxP3JgwvS5pmq7Vri1Jx9i_N2Mq4oXm5uTA8x7OeRC6JDAmoOT1zXI5hh-P8pgeoSGJKY-4pPFx-IMUEcSEDtCZ928AhCoGp2jAqFSCUTFET9N23dWV0X3VNh5Pit46PG9Lj-eVce3K6a6sDF5u3Mq6Ha4a_BxQ2_SBXdkcJzHWTY4XdW7dOTopdO3txWcdode725fpQzRb3D9OJ7PI8LBBZIHFyhSCMhMb0CwzoDImRS4zbRLFiSEJM0KAopJmMrM8AEJZo4WUkmdshPhhbljQe2eLtHPVWrtdSiDdu0mDm_S3mxC7OsS6Tba2-XfoS0YAkgOwbeugwb_Xm611aWl13Zf_zeZ_RAPFwy1JRIESoKGN9knJPgB8M36S</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Nemer, Kathleen M.</creator><creator>Ko, James J.</creator><creator>Hurst, Eva A.</creator><general>Lippincott Williams & Wilkins</general><general>by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20210201</creationdate><title>Complications After Mohs Micrographic Surgery in Patients Aged 85 and Older</title><author>Nemer, Kathleen M. ; Ko, James J. ; Hurst, Eva A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4012-e0359cf623c5c0a3bc09b376d7bac8941c183c6609272b7be4c0969eca67774b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age Factors</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - administration & dosage</topic><topic>Anticoagulants - adverse effects</topic><topic>Extremities</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Mohs Surgery - adverse effects</topic><topic>Neoplasm Staging</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Skin - pathology</topic><topic>Skin Neoplasms - diagnosis</topic><topic>Skin Neoplasms - pathology</topic><topic>Skin Neoplasms - surgery</topic><topic>Surgical Flaps - adverse effects</topic><topic>Surgical Flaps - transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nemer, Kathleen M.</creatorcontrib><creatorcontrib>Ko, James J.</creatorcontrib><creatorcontrib>Hurst, Eva A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Dermatologic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nemer, Kathleen M.</au><au>Ko, James J.</au><au>Hurst, Eva A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complications After Mohs Micrographic Surgery in Patients Aged 85 and Older</atitle><jtitle>Dermatologic surgery</jtitle><addtitle>Dermatol Surg</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>47</volume><issue>2</issue><spage>189</spage><epage>193</epage><pages>189-193</pages><issn>1076-0512</issn><eissn>1524-4725</eissn><abstract>BACKGROUNDAs the US population ages, safe surgical procedures are necessary for treatment of cutaneous neoplasms in very elderly patients.
OBJECTIVETo determine the incidence of complications associated with Mohs micrographic surgery (MMS) in patients aged 85 and older, and the risk factors that predispose to complications.
METHODSA 9-year retrospective chart review of patients aged 85 and older who underwent MMS at our institution between 07/2007 and 11/2016 was performed. Six types of complications associated with scalpel-based cutaneous surgery were recorded, as well as patient, tumor, and repair characteristics.
RESULTSThis study included 949 patients totaling in 1683 MMS cases. There were 30 complicationsinfection (N = 11), wound dehiscence (N = 6), hematoma (N = 6), hemorrhage (N = 5), flap necrosis (N = 1), and graft necrosis (N = 1), resulting in an overall complication rate of 1.78%. Independent risk factors associated with a statistically higher incidence of complications were anticoagulant use (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.26–6.13; p = .012), extremity location (OR, 2.80; 95% CI, 1.19–6.54; p = .018), greater than 2 MMS stages (OR, 2.43; 95% CI, 1.08–5.46; p = .032), and flap repair (OR, 2.27; 95% CI, 1.05–4.90; p = .036).
CONCLUSIONMohs micrographic surgery is a safe procedure for treatment of cutaneous neoplasms in the very elderly.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>32796326</pmid><doi>10.1097/DSS.0000000000002452</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Age Factors Aged, 80 and over Anticoagulants - administration & dosage Anticoagulants - adverse effects Extremities Female Humans Incidence Male Mohs Surgery - adverse effects Neoplasm Staging Postoperative Complications - epidemiology Postoperative Complications - etiology Retrospective Studies Risk Factors Skin - pathology Skin Neoplasms - diagnosis Skin Neoplasms - pathology Skin Neoplasms - surgery Surgical Flaps - adverse effects Surgical Flaps - transplantation |
| title | Complications After Mohs Micrographic Surgery in Patients Aged 85 and Older |
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