http://www.ncbi.nlm.nih.gov/pubmed/12269881 Dermatol Surg. 2002 Sep;28 9!:8"#$#1.

The advantages of delayed nasal full-thickness skin grafting after Mohs micrographic surgery.
%obin&on '() Dillig *.

Author information Abstract

BACKG !"#$% +ull$thic,ne&& &,in gra-ting -ollowing .oh& micrographic &urger/ ..S! o- the na&al tip and ala provide& ea&/ po&toperative wound care and avoid& -unctional impairment cau&ed b/ wound contraction o- the na&al ala -ree margin&. Direct compari&on o- immediate and dela/ed &,in gra-ting determined which o--er& greater &ucce&& and de-ined -actor& contributing to &ucce&&. !B&'CT()'% 0o determine i- dela/ed or immediate -ull$thic,ne&& &,in gra-ting re&ult& in better gra-t &urvival with improved -unction and appearance) and to identi-/ the recipient bed characteri&tic&) including the &i1e o- the wound) the proportion o- the wound ba&e having perichondrium) denuded cartilage) and granulation ti&&ue) and gra-t &urvival -or each techni2ue. M'T*!$+% 3e u&ed a pro&pective &tud/ comparing 200 patient& with wound& having a 4$# cm2 &ur-ace area repaired immediatel/ with a -ull$thic,ne&& &,in gra-t +0S*! to 200 patient& with a dela/ed +0S*. 0he depth and diameter o- the wound o- the na&al ala and tip) and characteri&tic& o- recipient bed including &i1e cm2!) location) proportion o- wound ba&e with perichondrium pre&ent) denuded cartilage) granulation ti&&ue) and proportion o- gra-t lo&& were the main outcome& mea&ured. '+",T+% 5artial gra-t lo&& occurred in 116 o- tho&e having dela/ed &,in gra-t& and 406 o- tho&e with immediate repair. Dela/ed gra-ting wa& a&&ociated with a larger wound &ur-ace area 5 7.0001!) more denuded cartilage 5 8.019!) greater e:po&ed perichondrium 5 7.0001!) and le&& partial gra-t lo&& 5 7.001!. 3hen partial gra-t lo&& occurred) the area o- lo&& wa& &maller with dela/ed +0S* 5 8.046!. ;ontraction o- the wound and &ub&e2uent na&al valve

impairment occurred le&& o-ten with dela/ed +0S* 5 7.0001!. *ra-t depre&&ion wa& &igni-icantl/ le&& with dela/ed +0S* o- the ala 5 7.0001! and al&o improved on the na&al tip 5 8."9!. C!#C,"+(!#% 0hi& pro&pective clinical trial o- immediate and dela/ed +0S*& o- the na&al tip and ala with denuded cartilage &howed improved gra-t &urvival in ca&e& where gra-ting wa& dela/ed -or 12$1" da/&. During thi& period) &ub&tantial granulation ti&&ue -ormed in the wound ba&e. <&&e&&ment o- the wound ba&e and the pre&ence o- granulation ti&&ue are ,e/ -actor& in the &ucce&& o- -ull$thic,ne&& &,in gra-ting.