National Trends in Repair Type Selection After Mohs Micrographic Surgery: A Benchmark Analysis Using TriNetX.

IF 2.2 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery Pub Date : 2025-09-03 DOI:10.1097/DSS.0000000000004851

Travis S Dowdle, Madelyn Schmidt, Frank T Winsett, Richard F Wagner

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引用次数: 0

Abstract

Background: Following histologic tumor clearance in Mohs micrographic surgery, reconstruction plays a critical role in patient outcomes. Despite its importance, national-level data on real-world reconstructive patterns by anatomic site are lacking.

Objective: Characterize national repair patterns by anatomic site following Mohs micrographic surgery.

Methods: Using the TriNetX research network, we extracted Mohs micrographic surgery cases performed between 2006 and 2024 (N = 607,214) and categorized repairs into reconstructive classes using CPT groupings. Cases were stratified by anatomic subunit using ICD-10 codes. Temporal trends and statistical significance were assessed using chi-squared tests.

Results: Our analysis revealed the following distribution of repair types across all sites: complex repairs (34%), no same day repair (19%), local flaps (19%), intermediate repairs (18%), skin grafts (8%), interpolation flaps (0.8%), island pedicle flaps (0.1%), and simple closures (1.0%). Utilization of island pedicle flaps and complex repairs declined significantly over time (P<0.0001), coinciding with CPT coding revisions, while intermediate repair use increased. Local flaps, skin grafts, and no same day repair remained relatively stable but trended downward over time.

Conclusion: This study provides valuable insights for Mohs surgeons seeking to benchmark their own reconstructive practices as understanding one's practice patterns in relation to national norms is critical.

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莫氏显微摄影手术后修复类型选择的全国趋势：使用TriNetX的基准分析。

背景：在Mohs显微摄影手术中，组织学肿瘤清除后，重建在患者预后中起着关键作用。尽管它很重要，但缺乏解剖部位真实世界重建模式的国家级数据。目的：通过莫氏显微摄影手术后的解剖部位来描述全国的修复模式。方法：使用TriNetX研究网络，我们提取了2006年至2024年间进行的Mohs显微摄影手术病例（N = 607,214），并使用CPT分组将修复分为重建类。采用ICD-10编码按解剖亚基分层。采用卡方检验评估时间趋势和统计学显著性。结果：我们的分析显示修复类型在所有部位的分布如下：复杂修复（34%），非当日修复（19%），局部皮瓣（19%），中间修复（18%），皮肤移植（8%），内插皮瓣（0.8%），岛状蒂皮瓣（0.1%）和简单关闭（1.0%）。随着时间的推移，岛状蒂皮瓣和复杂修复的使用率显著下降(结论：本研究为寻求自己的重建实践基准的莫氏外科医生提供了有价值的见解，因为了解与国家规范相关的实践模式至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatologic Surgery 医学-皮肤病学

CiteScore

3.10

自引率

16.70%

发文量

547

期刊介绍： Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.