Safety of the Use of Interpolation Flaps in Combination With Random Pattern Flaps or Skin Grafts for Repair of Post-Mohs Surgical Defects: A Cohort Study
Tess Lukowiak, Jessica Padniewski, Chandler Rundle, Morgan Dykman, Adam Mattox, Colby Presley, Ian MaherBACKGROUND
Reconstruction after Mohs micrographic surgery (MMS) for large or complex defects may require combination techniques, including interpolated flaps plus local flaps and/or skin grafts. Outcomes after combination repairs are not well-characterized.
OBJECTIVE
To assess postoperative complications associated with combination repairs using interpolation flaps with local flaps or full-thickness skin grafts (FTSG).
METHODS AND MATERIALS
A single-center retrospective review of patients who underwent MMS with reconstruction using an interpolated flap plus a local flap and/or skin graft from January 1, 2018, to August 1, 2025, was performed. Demographic, tumor, and reconstructive data were collected. Primary outcomes included postoperative complications within 3 months.
RESULTS
Twenty-one patients met inclusion criteria. The most common combination repair was a cheek-to-nose interpolation flap plus a local flap. Pain requiring prescription analgesia occurred in 23.81% of patients. Three patients (14.29%) experienced partial (2) or total (1) flap necrosis. Infection rate was 9.52% (2/21). No bleeding, dehiscence, hospitalizations, or emergency visits were observed.
CONCLUSION
Combination reconstruction seems safe in the outpatient setting with low rates of major complications, supporting its use for complex defects while emphasizing counseling regarding pain and flap viability.