Reconstruction After Skin Cancer Resection
Publication Date: April 27, 2021
Recommendation Statements for Reconstruction after Skin Cancer Resection
The work group finds that it is acceptable that clinicians perform reconstructive surgery in a delayed (asynchronous) fashion for adult patients after skin cancer resection. (Option, B/H, L)
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The work group suggests that clinicians should not routinely prescribe systemic antibiotic therapy in the interim between resection and reconstruction for adult patients undergoing reconstruction after skin cancer resection. (Weak, B, L)
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The work group suggests that clinicians may administer perioperative (i.e., no more than 24 hours before surgery) systemic antibiotics for adult patients undergoing reconstruction after skin cancer resection in a facility (non–office-based) setting (Weak, B, L)
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The work group recommends that clinicians should not routinely administer perioperative systemic antibiotics for adult patients undergoing reconstruction after skin cancer resection in the office-based setting. (Moderate, B, M)
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The work group recommends that clinicians should continue anticoagulant, antithrombotic, and antiplatelet medications for adult patients undergoing reconstruction after skin cancer resection in the office-based setting. (Moderate, B, M)
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The work group recommends that clinicians should coordinate with the physician managing the anticoagulation medication before modifying the medication prior to reconstruction procedures in a facility (non–office-based) setting. (NP, B, N/A)
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The work group recommends that clinicians should not routinely prescribe narcotic medication as first-line treatment for pain in adult patients undergoing reconstruction after skin cancer resection. (Moderate, B, M)
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The work group recommends that clinicians should prescribe acetaminophen and nonsteroidal anti-inflammatory drugs as first-line therapy in adult patients undergoing reconstruction for skin cancer resection. (Moderate, B, M)
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The work group suggests that clinicians discuss management of pain, antibiotics, and anticlotting agents with adult patients undergoing reconstruction after skin cancer resection when relevant. (NP, B, N/A)
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The work group suggests that clinicians may offer postoperative follow-up assessment to adult patients undergoing reconstruction after skin cancer resection. (NP, B, N/A)
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Title
Reconstruction After Skin Cancer Resection
Authoring Organizations
American Academy of Dermatology
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Otolaryngology - Head and Neck Surgery Foundation
American Society for Dermatologic Surgery
American Society of Plastic Surgeons
Publication Month/Year
April 27, 2021
Country of Publication
US
Document Objectives
This guideline provides evidence-based recommendations for surgical reconstruction after resection of skin cancer once clear margins have been achieved.
Target Patient Population
Adult patients in the process of reconstruction, assuming that the skin cancer is resected and the margins are clear of tumor
Target Provider Population
Plastic surgeons, dermatologists, otolaryngologists and other clinicians who perform reconstructive procedures
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Hospital, Outpatient, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Diseases/Conditions (MeSH)
D019651 - Reconstructive Surgical Procedures
Keywords
resection, skin cancer, reconstruction, skin reconstruction
Source Citation
Chen A, Albertini JG, Bordeaux JS, Chen MW, Cook JL, Davidson C, Donnelly KC, Galaria II, Hannan CM, Kantor J, Kapp DL, Lawrence N, Lober CW, Loeding LD, Miller A, Ness DT, Neves RI, Revenaugh PC, Setabutr P, Tholpady SS, Tollefson TT, Van Beek MJ, Weiss PR, Alam M. Evidence-Based Clinical Practice Guideline: Reconstruction after Skin Cancer Resection. Plast Reconstr Surg. 2021 May 1;147(5):812e-829e. doi: 10.1097/PRS.0000000000007789. PMID: 33890904.