Secondary intention healing of exposed scalp and forehead bone after Mohs surgery

For Mohs surgical wounds that show exposed bone (ie, bone denuded of perios teum), healing by secondary intention may be preferable to surgical reconst ruction. To determine the appropriateness of secondary intention healing, w e reviewed surgical outcome in 205 patients with Mohs wounds of the scalp a nd forehead that had healed by secondary intention. Of these patients, 38 h ad Mohs wounds showing exposed bone. The mean area of exposed bone was 1074 mm(2); the mean area of exposed soft tissue was 1575 mm(2). The mean time for wounds with intact periosteum to epithelialize was 7 weeks; the mean ti me for bare bone to epithelialize was 13 weeks. All wounds healed without i nfection or tissue breakdown. We conclude that secondary intention healing of scalp and forehead wounds showing exposed bone is a safe and effective m ethod of wound management after Mohs surgery.