How good is secondary intention healing post nasal cutaneous tumour excision?
By Shivanchan Rajmohan

The variation in size and site of nasal cutaneous tumours allows the surgeon to propose various methods to close the resulting defect post-tumour excision. This prospective multicentre cohort study executed in China encompassed 150 patients, comparing wound healing times and final cosmetic outcomes of secondary intention healing versus flap transfer following nasal cutaneous tumour excision. Secondary intention healing groups had regular advanced dressings impregnated with recombinant antimicrobial peptides and lysozyme fusion proteins. Specifically, primary outcomes included wound healing to complete epithelialisation, scar quality and overall cosmesis. Patient satisfaction and comprehensive scar characteristics formed the secondary outcome measures. Utilising the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS), the secondary intention healing cohort demonstrated superior scar quality including better vascularity, pliability, pigmentation, colour and contour in addition to enhanced patient satisfaction and overall experience six months postoperatively. The flap transfer cohort had significantly better thickness compared to secondary intention healing cohort, as one might predict. Interestingly, multivariate logistic regression analysis demonstrated male subjects to be less satisfied compared to female counterparts in the secondary intention healing group. Deeper wound defects had lower satisfaction rates compared to superficial defects in the secondary intention healing group. Historically secondary intentional healing has been a traditional closure method for centuries but, due to prolonged healing times, it is often met with mixed reactions. This is where a myriad of patient and environmental factors play a key role into choice of closure method which should, where feasible, be a joint decision between patient and surgeon. With the nose being a central feature of the face, scar quality is imperative; this study illustrates the skin’s forgiving nature with its regenerative properties and, therefore, supports secondary intention healing as a viable closure method of defects following nasal cutaneous tumour excision.

Association of flap transfer versus excision with secondary healing on patient satisfaction in nasal mass surgery: A cohort study.
Li X, Li D, Li Y, et al.
J PLAST RECONSTR AESTHET SURG
2025;100:309–16.