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Evidence-based clinical practice guideline: Reconstruction after skin cancer resection - 08/07/21

Doi : 10.1016/j.jaad.2021.03.015 
Andrew Chen, MD , John G. Albertini, MD, Jeremy S. Bordeaux, MD, MPH, Michael W. Chen, MD, Jonathan L. Cook, MD, Caryn Davidson, MS, Katelyn C. Donnelly, MPH, Irfan I. Galaria, MD, MBA, Catherine M. Hannan, MD, Jonathan Kantor, MD, MSCE, Daniel L. Kapp, MD, Naomi Lawrence, MD, Clifford W. Lober, MD, JD, Lauren D. Loeding, MPH, Alexander Miller, MD, Daniel T. Ness, MD, Rogerio I. Neves, MD, PhD, Peter C. Revenaugh, MD, Peter Setabutr, MD, Sunil S. Tholpady, MD, PhD, Travis T. Tollefson, MD, MPH, Marta J. Van Beek, MD, MPH, Paul R. Weiss, MD, Murad Alam, MD, MSCI, MBA
 University of Connecticut 
 The Skin Surgery Center 
 University Hospitals Cleveland Medical Center/Case Western Reserve University 
 Kaiser Permanente 
 Duke University Medical Center 
 American Society of Plastic Surgeons 
 Galaria Plastic Surgery and Dermatology 
 Veterans Affairs Medical Center 
 Florida Center for Dermatology 
 Department of Dermatology, University of Pennsylvania Perelman School of Medicine 
 Private practice 
 Cooper Medical Center, Rowan University 
 University of South Florida 
 University of Central Florida 
 University of California, Irvine 
 Piedmont Plastic Surgery and Dermatology 
 Pennsylvania State University 
 Rush University Medical Center 
 University of Illinois at Chicago 
 R. L. Roudebush Veterans Affairs Medical Center 
 University of California, Davis, Medical Center 
 University of Iowa Hospitals & Clinics 
 Private practice 
 Northwestern University 

Correspondence to: Andrew Chen, MD, Division of Plastic Surgery, University of Connecticut, 263 Farmington Avenue, Farmington, CT, 06030.Division of Plastic SurgeryUniversity of Connecticut263 Farmington AvenueFarmingtonCT06030

Summary

A multi-disciplinary work group involving stakeholders from various backgrounds and societies was convened to develop guidelines for the management of reconstruction after skin cancer resection. The goal was to identify areas of common ground and provide evidence-based recommendations to improve patient care. Given the heterogeneity of reconstructive techniques and clinical scenarios, investigation centered around common elements in the process. In some cases, a distinction was made between treatment options in the office-based setting as opposed to those in the facility setting. A systematic literature review was performed, and an established appraisal process was used to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development, and Evaluation methodology). Final recommendations are related to concepts concerning the timing of reconstruction, management of anticoagulation, use of antibiotics, methods of pain control, and follow-up assessment. At times, there was insufficient evidence to make high-level recommendations. The literature analysis highlights the need for additional methodologically robust studies in this area, to help guide clinical practice.

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 Disclosure: This clinical practice guideline was funded by the American Society of Plastic Surgeons with support from the American Society for Dermatologic Surgery; no outside commercial funding was received to support the development of this document. Each organization paid travel expenses for members to attend face-to-face meetings. For detailed disclosures for each author, see the Disclosure Appendix at the end of this article.
 This article has been co-published with permission in the Plastic and Reconstructive Surgery, Dermatologic Surgery, and the Journal of the American Academy of Dermatology. All rights reserved in respect of American Society of Plastic Surgeons, American Society for Dermatologic Surgery, American Academy of Dermatology, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaiyngology—Head and Neck Surgery, American College of Mohs Surgery, American Society for Mohs Surgery, and American Society of Ophthalmic Plastic and Reconstructive Surgery.


© 2021  American Society of Plastic Surgeons, American Society for Dermatologic Surgery, American Academy of Dermatology, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology--Head and Neck Surgery, American College of Mohs Surgery, American Society for Mohs Surgery, and American Society of Ophthalmic Plastic and Reconstructive Surgery. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 85 - N° 2

P. 423-441 - août 2021 Regresar al número
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