A retrospective study on the outcomes of Mohs micrographic surgery for non-melanoma skin cancers using tri-layer amniotic membrane

Abstract

Background: Non-melanoma skin cancers (NMSC), primarily basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), represent the most common malignancies worldwide. Mohs micrographic surgery (MMS) plays a crucial role in the management of these tumors, providing precise tumor clearance while maximizing the preservation of surrounding healthy tissue. Despite these advantages, post-surgical wound reconstruction for larger wounds and in specific anatomical locations can pose a challenge to the surgeon. Convex anatomic locations and poorly vascularized tissues (e.g., periosteum, cartilage, distal third of the lower extremities) may require months to heal. Healing time is influenced by wound size, depth, vascularity, and patient comorbidities. Cellular, acellular, and matrix-like products (CAMPs), such as tri-layered amniotic membrane (Amnio Tri-Core, Stability Biologics), have emerged as a promising reconstructive option. Objective: This retrospective study evaluated the clinical outcomes of patients undergoing MMS for the removal of NMSC. The post-surgical wounds were reconstructed using weekly applications of a tri-layered amniotic membrane. Analysis included time to complete closure and percentage wound area reduction (PAR). Methods: This multicenter study included 46 adult patients who underwent MMS for NMSC on regions such as the face, limbs, and neck. Patients with allergies to specific processing agents or incomplete records were excluded. Patients were divided into two groups: male (n=28) and female (n=18). The collected data included demographics, medical history, wound characteristics (type, location, and size), treatment details, and outcomes. Results: Complete closure was achieved in an average of 8.53 weeks. Conclusion: The results of this study suggest that wounds treated with tri-layer amniotic membrane after MMS can experience accelerated healing.

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