PC30. Utilizing Integra for Reconstruction of Facial Defects after Mohs Micrographic Surgery

PURPOSE: We aim to identify how Integra bilayer wound matrix has expanded facial reconstruction options after Mohs surgery due to its reliability in both single- and dual-stage reconstruction. METHODS: A retrospective review of patients undergoing Mohs surgery and alloplastic facial reconstruction with Integra between 2012-2022 was performed. Patients who underwent single-stage reconstruction and dual-stage reconstruction with skin graft with at least 90 days of follow up were included. RESULTS: One hundred thirty-two patients (86 males, 46 females) with a mean age of 74 years were included. Basal cell carcinoma was the most common malignancy (39%). One hundred forty-four lesions were treated and reconstructed same-day with Integra. Lesions most commonly involved the nose (34%) and forehead (22%). The mean post-operative defect size was 26.9cm2. 45.5% (n=60) of defect sites underwent single-stage Integra reconstruction with healing by secondary intention, while 54.5% (n=72) underwent dual-stage reconstruction with skin graft. Integra success rate was 90.2%. Average time to completed healing was 169.5 + 14.6 days. The complication rate was 12.8% (n=17), with 12 undergoing debridement, 3 needing placement of a new Integra graft, and 7 needing a new skin graft. The average size for successful healing without complication was 26.6 cm2. Nineteen sites (13.2%) underwent aesthetic improvement procedures with the majority occurring after dual-stage reconstruction (n=13). CONCLUSION: Integra is a reliable outpatient reconstructive option for facial Mohs defects that can increase the threshold for autologous flap harvesting and successfully reconstruct large defects of 26.6cm2 on average with low complication and reoperation rates.