Delayed Full-Thickness Skin Grafting After Skin Cancer Resection: A Systematic Review

BACKGROUND: Reconstruction after Mohs micrographic surgery (MMS) or wide local excision (WLE) requires careful consideration of defect size, location, depth, margin status, and patient preferences to optimize cosmetic, functional, and oncologic outcomes. The role of delayed full-thickness skin grafts (FTSGs) during reconstruction after skin cancer removal remains less defined. OBJECTIVE: To characterize the indications, technique, and efficacy of delayed FTSG after MMS or WLE for skin cancer. MATERIALS AND METHODS: Databases were searched for studies on delayed FTSG after MMS or WLE for skin cancer removal. Data were extracted on study design, patient and tumor characteristics, surgical details, graft technique, and outcomes including graft success, complications, and aesthetic/functional results. RESULTS: Twenty-four studies comprising 665 patients were included. The mean age was 63.8 years, and most patients were male (52.6%). The average delay to grafting was 16.5 days, with an overall graft success rate of 89.6% at an average follow-up period of 13 months. The optimal time to delay was 2 to 3 weeks with grafts placed in ≤1 week demonstrating significantly lower success. Outcomes were overall assessed as favorable, and patients were satisfied with their results. CONCLUSION: Delayed FTSGs remain a viable and highly effective option for reconstructing skin cancer defects.