“Mosaic graft” technique and surgical dermal glue in Mohs micrographic surgery and general dermatologic surgery

After Mohs micrographic surgery, derm surgeons utilize local flaps, full or partial thickness grafts, with good or acceptable cosmetic results. When we are dealing with older and problematic patients, blood thinner users, and non-collaborative people with large facial neoplasms, using flaps may be very difficult, and grafts become the best choice. Our aim was to assess a technique to graft very easily, quickly, and safely, full-thickness skin grafts in facial wounds, and have good cosmetic results in those older and problematic people. Ten elderly patients who underwent Mohs surgery or other surgical procedures have been grafted with this technique that we called “mosaic graft”, made possible using a dermal glue in a new way. In some cases, for bigger defects, we also assessed the “stripes” variant of this technique. Graft survival was almost always complete in all cases, and after 6 months the cosmetic outcomes were good. This “mosaic graft” technique and its “stripes” variant showed good reliability, fast execution, easy harvesting with tissue saving, and good cosmetic outcomes, making this technique a very good choice for older and problematic patients.