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• W2078889709 abstract "To the Editor: Nonmelanoma skin cancer (NMSC) is the most common cancer worldwide, and its incidence is increasing;1 these facts and the aging of the population in the developed world suggest that dermatologists will be faced with an increasing number of very elderly adults presenting with skin cancers.2 Several studies have analyzed the outcome of surgery in elderly adults in other surgical disciplines but few in dermatological surgery. Some authors have demonstrated that skin surgery is a safe and effective therapy in elderly adults.3 The most important decision is how best to treat these patients with these skin conditions that progress slowly and are usually not fatal.4 This study was conducted in the Dermatology Department of University Hospital, Elche, Spain. The study group consisted of individuals aged 80 and older treated with surgery for NMSC. For each individual included, a patient younger than 80 treated with surgery for NMSC was included in a control group. The principal investigator (JCP) reported complications from surgery (classified as hemorrhagic (postoperative hemorrhage, hematoma, ecchymosis), infectious, wound dehiscence, and flap or graft necrosis) during routine procedures. Each group had 130 subjects, and 320 tumors were removed (163 in the older group, 157 in the control group). Baseline demographic characteristics and complications are summarized in Table 1. Solid basal cell carcinoma was the most common diagnosis in both groups. Most tumors were located on the head and neck. The most common type of closure in both groups was direct closure, skin flaps were frequently used, but skin grafts were more commonly used in the older subjects (P = .005). The incidence of complications from cutaneous surgery was low (excluding ecchymoses). Hemorrhagic complications were more common in the older group (P = .04), but most were only ecchymoses, with one postoperative bleeding in the whole study. Only three wound infections were recorded, all in the older group. The skin of the elderly adults is vulnerable to trauma and poor wound repair.5 Elderly adults with NMSC are commonly excluded from dermatological surgery exclusively because of their age,6 but greater morbidity with dermatological surgery in older adults has not been detected.7, 8 The current study found a low rate of complications, even with the frequent use of flaps and grafts in both groups. Only hemorrhagic complications were more common in the older group, probably because of loss of elastic fibers and collagen in elderly adults, which is associated with greater skin fragility. The main limitations of the study were the small number of participants and that it was performed in a single institution. The results of this study suggest that complications from dermatological surgery are similar in older and younger adults and that surgery is a viable treatment in very elderly adults with NMSC. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Author Contributions: All authors contributed to writing this letter. Sponsor's Role: There were no sponsors or funding for this paper." @default.
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• W2078889709 date "2015-01-01" @default.
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• W2078889709 title "Cutaneous Surgery Complications in Individuals Aged 80 and Older Versus Younger Than 80 After Excision of Nonmelanoma Skin Cancer" @default.
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• W2078889709 doi "https://doi.org/10.1111/jgs.13226" @default.
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