Autologous Patch Healing vs Secondary Intent Healing after Mohs Micrographic Surgery: A Randomized Controlled Trial
DOI:
https://doi.org/10.2340/actadv.v106.43586Keywords:
basal cell carcinoma, Mohs surgery, wound healingAbstract
Secondary intent healing is a viable option for wound closure after facial tumour removal by Mohs micrographic surgery. Secondary intent healing involves prolonged healing time and carries risk of infection and complications related to scarring. Healing with an autologous patch made from the patient’s own blood may be beneficial. This study on 22 patients evaluates the effect of applying an autologous patch to the wound after Mohs micrographic surgery. A randomized controlled assessor-blinded trial was carried out. Patients had Mohs micrographic surgery on day 0 and clinical evaluation on day 12, day 19, and after 6 months. Transepidermal water loss was measured on day 12 and day 19. Reflectance confocal microscopy was applied exploratively. At 6 months’ follow-up the Patient and Observer Scar Assessment Scale was evaluated. Primary outcome was fully epithelialized wounds on day 19 and secondary outcome was 50% epithelialized wounds on day 12. One wound from each group was fully epithelialized and wound area reduction was higher in the patch group although not significant. Transepidermal water loss decreased to a larger extent, indicating that the patch creates a moist environment. Wound healing with an autologous patch is equivalent to secondary intent healing but may prompt benefits in certain wound healing factors. Patch healing appears safe with high patient satisfaction.
Downloads
References
Enache AO, Pătrașcu V, Simionescu CE, Ciurea RN, Văduva A, Stoica LE. Dermoscopy patterns and histopathological findings in nodular basal cell carcinoma: study on 68 cases. Curr Health Sci J 2019; 45: 116–122.
Van Der Eerden PA, Verdam FJ, Dennis SCR, Vuyk H. Free cartilage grafts and healing by secondary intention: a viable reconstructive combination after excision of nonmelanoma skin cancer in the nasal alar region. Arch Facial Plast Surg 2009; 11: 18–23. DOI: https://doi.org/10.1001/archfaci.2008.501
Brown BC, McKenna SP, Siddhi K, McGrouther DA, Bayat A. The hidden cost of skin scars: quality of life after skin scarring. J Plast Reconstr Aesthet Surg 2008; 61: 1049–1058. DOI: https://doi.org/10.1016/j.bjps.2008.03.020
Ziolkowski N, Kitto SC, Jeong D, Zuccaro J, Adams-Webber T, Miroshnychenko A, et al. Psychosocial and quality of life impact of scars in the surgical, traumatic and burn populations: a scoping review protocol. BMJ Open 2019; 9: e021289. DOI: https://doi.org/10.1136/bmjopen-2017-021289
Zitelli JA. Secondary intention healing: an alternative to surgical repair. Clin Dermatol 1984; 2: 92–106. DOI: https://doi.org/10.1016/0738-081X(84)90031-2
Ranjbar_moghaddam M, Merajikhah A, Mahdood B, Mousavi E, Bastami M. Analyzing outcomes of platelet-rich plasma usage on surgical wounds: a systematic review. Curr Probl Surg 2025; 64: 101704. DOI: https://doi.org/10.1016/j.cpsurg.2024.101704
Chicharro-Alcántara D, Rubio-Zaragoza M, Damiá-Giménez E, Carrillo-Poveda JM, Cuervo-Serrato B, Peláez-Gorrea P, et al. Platelet rich plasma: new insights for cutaneous wound healing management. J Funct Biomater 2018; 9: 10. DOI: https://doi.org/10.3390/jfb9010010
Ahmad Z, Howard D, Brooks RA, Wardale J, Henson F, Getgood A, et al. The role of platelet rich plasma in musculoskeletal science. JRSM Short Rep 2012; 3: 1–9. DOI: https://doi.org/10.1258/shorts.2011.011148
Ågren MS, Rasmussen K, Pakkenberg B, Jørgensen B. Growth factor and proteinase profile of Vivostat® platelet-rich fibrin linked to tissue repair. Vox Sang 2014; 107: 37–43. DOI: https://doi.org/10.1111/vox.12120
Jørgensen B, Karlsmark T, Vogensen H, Haase L, Lundquist R. A pilot study to evaluate the safety and clinical performance of Leucopatch, an autologous, additive-free, platelet-rich fibrin for the treatment of recalcitrant chronic wounds. Int J Low Extrem Wounds 2011; 10: 218–223. DOI: https://doi.org/10.1177/1534734611426755
Chavez-Bourgeois M, Ribero S, Barreiro A, Espinosa N, Carrera C, Garcia A, et al. Reflectance confocal microscopy and electrical impedance spectroscopy in the early detection of melanoma in changing lesions during long-term follow-up of very high-risk patients. Acta Derm Venereol 2022; 102: adv00751. DOI: https://doi.org/10.2340/actadv.v102.1105
von Knorring T, Møller Israelsen N, Ung V, Formann JL, Jensen M, Haedersdal M, et al. Differentiation between benign and malignant pigmented skin tumours using bedside diagnostic imaging technologies: a pilot study. Acta Derm Venereol 2022; 102: adv00634. DOI: https://doi.org/10.2340/actadv.v101.571
del Río-Sancho S, Christen-Zaech S, Alvarez Martinez D, Pünchera J, Merat R, Laubach HJ. Comparing line-field confocal optical coherence tomography and reflectance confocal microscopy on the in vivo healing process of lesions induced by fractional photothermolysis. Lasers Surg Med 2025; 57: 121–129. DOI: https://doi.org/10.1002/lsm.23841
Guida S, Longo C, Amato S, Rossi AM, Manfredini M, Ciardo S, et al. Laser treatment monitoring with reflectance confocal microscopy. Medicina (Kaunas) 2023; 59: 1039. DOI: https://doi.org/10.3390/medicina59061039
Game F, Jeffcoate W, Tarnow L, Jacobsen JL, Whitham DJ, Harrison EF, et al. LeucoPatch system for the management of hard-to-heal diabetic foot ulcers in the UK, Denmark, and Sweden: an observer-masked, randomised controlled trial. Lancet Diabetes Endocrinol 2018; 6: 870–878. DOI: https://doi.org/10.2337/db18-638-P
Löndahl M, Tarnow L, Karlsmark T, Lundquist R, Nielsen AM, Michelsen M, et al. Use of an autologous leucocyte and platelet-rich fibrin patch on hard-to-heal DFUs: a pilot study. J Wound Care 2015; 24: 172–178. DOI: https://doi.org/10.12968/jowc.2015.24.4.172
Ehrlich HP, Freedman BM. Topical platelet-derived growth factor in patients enhances wound closure in the absence of wound contraction. Cytokines Cell Mol Ther 2002; 7: 85–90. DOI: https://doi.org/10.1080/13684730310001643
Van Loo E, Mosterd K, Krekels GAM, Roozeboom MH, Ostertag JU, Dirksen CD, et al. Surgical excision versus Mohs’ micrographic surgery for basal cell carcinoma of the face: a randomised clinical trial with 10 year follow-up. Eur J Cancer 2014; 50: 3011–3020. DOI: https://doi.org/10.1016/j.ejca.2014.08.018
Saba AA, Freedman BM, Gaffield JW, Mackay DR, Ehrlich HP. Topical platelet-derived growth factor enhances wound closure in the absence of wound contraction: an
experimental and clinical study. Ann Plast Surg 2002; 49: 62–66. DOI: https://doi.org/10.1097/00000637-200207000-00010
Liang Z, Lai P, Zhang J, Lai Q, He L. Impact of moist wound dressing on wound healing time: a meta-analysis. Int Wound J 2023; 20: 4410–4421. DOI: https://doi.org/10.1111/iwj.14319
Dyson M, Young S, Pendle CL, Webster DF, Lang SM. Comparison of the effects of moist and dry conditions on dermal repair. J Invest Dermatol 1988; 91: 434–439. DOI: https://doi.org/10.1111/1523-1747.ep12476467
Downloads
Additional Files
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2026 Marie K. Hjorth, Ewa A. Burian, Tonny Karlsmark, Mette Mogensen, Martin Glud, Anna Ahm Harager, Anthony Rossi, Katrine E. Karmisholt

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.