Autologous patch versus secondary intent healing for Mohs surgery wounds

Secondary intent healing is a viable option for wound closure after facial tumour removal by Mohs micrographic surgery. Secondary intent healing involves prolonged healing time and carries risk of infection and complications related to scarring. Healing with an autologous patch made from the patient's own blood may be beneficial. This study on 22 patients evaluates the effect of applying an autologous patch to the wound after Mohs micrographic surgery. A randomized controlled assessor-blinded trial was carried out. Patients had Mohs micrographic surgery on day 0 and clinical evaluation on day 12, day 19, and after 6 months. Transepidermal water loss was measured on day 12 and day 19. Reflectance confocal microscopy was applied exploratively. At 6 months' follow-up the Patient and Observer Scar Assessment Scale was evaluated. Primary outcome was fully epithelialized wounds on day 19 and secondary outcome was 50% epithelialized wounds on day 12. One wound from each group was fully epithelialized and wound area reduction was higher in the patch group although not significant. Transepidermal water loss decreased to a larger extent, indicating that the patch creates a moist environment. Wound healing with an autologous patch is equivalent to secondary intent healing but may prompt benefits in certain wound healing factors. Patch healing appears safe with high patient satisfaction.