Second intention healing for intermediate and large postsurgical defects of the lip

Abstract

The lip plays critical roles in both function and cosmesis. Many options exist for postsurgical reconstruction following excision or Mohs micrographic surgery on the lip. Second intention healing is generally reserved only for superficial and small postsurgical defects of the lip vermilion. We sought to evaluate second intention healing of the lip for intermediate and large partial thickness, postsurgical defects through a retrospective review of medical charts in conjunction with telephone interviews. Complication rates, time to reepithelialization, and patient satisfaction were determined for 25 patients who underwent second intention healing on the lip following Mohs micrographic surgery for non-melanoma skin cancer. The majority of patients in the study demonstrated good to excellent cosmetic and functional results with minimal complications. Time to complete reepithelialization averaged 25 days. Patient satisfaction with both the healing process and final cosmetic result was very high. The study is a small retrospective case series. Using patient satisfaction as a primary endpoint, a limiting factor may be recall bias. Second intention healing is an effective and satisfactory management strategy for intermediate and large postsurgical defects of the lip vermilion, including those with extension to cutaneous lip and underlying orbicularis muscle.