Immediate versus delayed repair of skin defects following resection of carcinoma

Facial defects resulting from excision of skin malignancies may be reconstructed with flaps or grafts immediately or in delayed fashion, or the wound may be allowed to heal by secondary intention. The merits of each option are discussed along with a brief review of the pertinent details of wound healing. A small delay in reconstruction of up to 3 to 4 days can be tolerated safely with no compromise of results. When healing by secondary intention is chosen, fenestration speeds coverage of the wound, and moist dressings with antibiotic ointment effectively prevent infection and expedite epithelization.