Association of flap transfer versus excision with secondary healing on patient satisfaction in nasal mass surgery: A cohort study

Abstract

Background

Nasal cutaneous tumors impact appearance and function, affecting the patients’ well-being. This study compares the outcomes of second intention healing, where wounds heal naturally, with flap transfer in nasal defect repair after tumor resection to evaluate its viability as an alternative.

Methods

In this multi-center study, 80 patients who underwent second intention healing and 70 patients who received flap transfer after nasal tumor resection between July 2018 and June 2023 were included. Patient demographics, tumor characteristics, operative details, and wound healing time were collected. Scar outcomes were evaluated at 6 months postoperation using the Vancouver scar scale and visual analog scale.

Results

The second intention healing group showed significantly better outcomes compared to the flap transfer group. The Vancouver scar scale score was lower in the second intention group (3.51 ± 0.22 vs. 3.98 ± 0.68, P = 0.02), indicating better scar quality. Superior outcomes were observed in vascularity, pigmentation, and pliability on the observer patient and observer scar assessment scale (POSAS) scale. Patients reported better color, irregularity, and higher satisfaction with wound care experience. The overall patient satisfaction score was significantly higher in the second intention group (7.59 ± 0.24 vs. 7.16 ± 0.10, P = 0.02).

Conclusion

This cohort study suggests that second intention healing is associated with higher patient satisfaction in nasal cutaneous tumor surgery compared to flap transfer. These findings support the possibility of using second intention healing as an alternative in nasal cutaneous tumor treatment. Further research is needed to validate these results.