Reconstruction After Skin Cancer Resection

Publication Date: April 26, 2021
Last Updated: March 14, 2022

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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Recommendation Grading

Overview

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 26, 2021

Last Updated Month/Year

April 1, 2024

Document Type

Guideline

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

Scope

Management

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.

Supplemental Methodology Resources

Data Supplement, Data Supplement