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Scientific Oral Presentation

Facial Plastic and Reconstructive Surgery

Comparing Wound Complications by Facial Anatomical Subsite During Mohs Surgery: A Multicenter Trinetx Study

Monday, October 19, 2026
1:18 PM - 1:24 PM PT
Location: 404A

    Presenting Author(s)

  • Andre Joseph Burnham, MD

    Resident Physician
    Washington University School of Medicine
    Saint Louis, MO, United States

    • Co-Author(s)

  • MW

    Mariel Watkins, MD

    Facial Plastic and Reconstructive Surgery Fellow
    Washington University/B-JH/SLCH Consortium, United States

  • PL

    Pablo Llerena, MD

    Resident Physician
    Washington University/B-JH/SLCH Consortium, United States

    • Senior Author(s)

  • Emily A. Spataro, MD

    Associate Professor
    Washington University in St. Louis
    St. Louis, Missouri, United States

Disclosure(s):
Andre Joseph Burnham, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Emily A. Spataro, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Mohs micrographic surgery (Mohs) is the preferred treatment for many skin cancers of the face. Although prior studies suggest that infection risk may vary by anatomical location, most analyses group head and neck sites together or rely on single-institution data; we compare wound complications following Mohs across head and facial subsites using the multicenter TriNetX database.

Methods: Adult patients undergoing Mohs for facial non-melanoma skin cancer were stratified by anatomical location using CPT and ICD-10 codes, including the eyelid/periocular region, lip, nose, external ear, and unspecified facial regions. The number of patients included for the face, eyelid, lip, nose, and ear cohorts respectively was 99329, 11604, 9943, 93401, and 21273. Surgical site infections (SSI), wound debridement, dehiscence, and revision reconstruction within 90 days of Mohs were identified using appropriate ICD-10 codes. Multivariable logistic regression was performed after propensity matching for demographics and comorbidities.

Results: Compared with Mohs of unspecified regions of the face (reference group), eyelid Mohs showed lower SSI rates (0.42% vs 0.73%; OR 0.58, 95% CI 0.41–0.82; p = 0.002), but higher rates of wound dehiscence (0.38% vs 0.24%; OR 1.61, 95% CI 1.00–2.58; p = 0.047) and postoperative debridement (0.41% vs 0.11%; OR 3.78, 95% CI 2.05–6.96; p < 0.0001). External ear Mohs was associated with higher SSI rates (1.06% vs 0.77%; OR 1.38, 95% CI 1.13–1.70; p = 0.002). SSI and dehiscence rates following lip and nasal surgery were comparable. Eyelid, lip, and external ear Mohs were each associated with significantly lower rates of revision reconstruction, whereas revision rates following nasal reconstruction were similar to those of unspecified facial reconstruction.

Conclusions: While overall complication rates were low, ninety-day complication profiles following Mohs and subsequent reconstruction differ by anatomic subsite. These findings provide clinically relevant data that may guide patient counseling and postoperative management.