Second Intent Healing Following Mohs Micrographic Surgery

After Mohs micrographic surgery (MMS) for skin cancer, wounds can be closed with stitches or left open to heal naturally—a process called second intent healing. While less commonly used today, this method can offer equal or better cosmetic and functional outcomes in the right settings. It works especially well on concave facial areas (nose, eye, ear, temple), scalp (reducing hair loss), and some trunk or limb sites, where scars may be smaller and less noticeable compared to surgical closure. Second intent healing also allows earlier detection of recurrence since no tissue is buried by reconstruction.

Benefits include fewer procedures, lower costs, and suitability for older or immunocompromised patients. Risks include more visible scarring on convex areas (cheeks, chin, lips), slower healing for large or deep wounds, and higher wound care demands, since daily dressing changes are required. It is not ideal for wounds near joints, deep periocular or perioral wounds, very large scalp defects, or patients with prior radiation. Most patients report high satisfaction with cosmetic results, wound care, and overall experience, making it an important alternative to surgical repair in selected cases.

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