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Large surgical defects after Mohs micrographic surgeries (MMS) often require rotation or advancement flaps, skin grafts, or delayed reconstruction after use of tissue expanders. For patients with limited tissue redundancy, wounds may also heal by secondary intention. Elderly patients undergoing MMS with full-thickness defects exposing bone pose a unique set of healing barriers, such as immunosuppression, increased infection risk, poor tolerance to bone chiseling for exposing pinpoint bleeding, and difficulty in reaching wounds to apply dressings successfully.
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Lyons et al. (2018) studied this question.
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