How Would You Reconstruct It? Post-Mohs Defects & Repair Options

The transcript discusses reconstructive options for patients post-Mohs surgery, focusing on three cases. The first case involves a man with a squamous cell carcinoma leading to a significant defect in his cheek. The speaker outlines various reconstruction techniques including rotation and transposition flaps, bilobe and trilobe flaps, and full-thickness skin grafts, noting the challenges posed by thick dermis and the need for oncological considerations due to the patient's post-operative radiation therapy. The second case features a 63-year-old man with a malignancy affecting his penis, where options to reconstruct the urethra include skin grafting and potentially a second-stage procedure. Panelists discuss techniques ranging from direct grafting to using full-thickness skin to form a urethra, emphasizing the importance of not underestimating the required graft size. The third case pertains to extra-mammary Paget's disease on the abdomen, exploring options like rhombic flaps and skin grafting. The panel emphasizes the need for careful tissue handling and considering secondary intention healing if needed. Overall, the discussions reflect the complexity of reconstructive surgery, highlighting diverse strategies and considerations based on individual patient needs.