No significant differences in complications in outpatient vs inpatient paramedian forehead flap repairs: A single-center retrospective study

Summary: Differences in complications after paramedian forehead flap (PMFF) repairs performed outpatient vs inpatient were assessed. Patients who underwent PMFF repair for facial defects from 1/1/2021 to 11/26/2024 were included. Extracted data included (among others): demographics, tobacco use, antithrombotic use, immunosuppressant use, defect information, flap details, days to takedown, local fibrinolytic use, bleeding (including phone calls, after-hours clinic or ER visits), flap necrosis, infection, and revision procedures. PMFF technique was utilized in all 126 cases. 32/126 of repairs were completed outpatient by a Mohs micrographic surgeon. 94/126 of repairs were completed inpatient. No significant differences in bleeding complications were observed between outpatient and inpatient repairs, including in patient calls (6/32 vs 8/94) and ER visits (2/32 vs 1/94). No significant differences were observed in the incidence of flap necrosis (2/32 vs 1/94) or infection (3/32 vs 4/94). When revisions were indicated, patients with PMFF repairs performed outpatient tended to undergo dermabrasion (10/32 vs 1/94) and intralesional corticosteroid (8/32 vs 1/94), while patients with PMFF repairs performed inpatient tended to undergo surgical revision (6/32 vs 21/94). 5/94 (5.3%) of patients with inpatient repairs required overnight admission. The mean takedown period significantly differed between outpatient (11.7 days) vs inpatient (32.9 days) procedures (-21.2 days (95% CI, -27.3 to -15.1, p<0.0001)). No significant differences in complications were observed between patients who underwent outpatient vs inpatient PMFF repair. Small sample size is a key limiting factor. Large reconstructions such as PMFF have similar outcomes when performed outpatient vs inpatient. Jeffrey Rajkumar¹, Marin P. Melloy², Maha Kazmi¹, Daniel B. Eisen¹ 1. University of California Davis Department of Dermatology, Sacramento, CA, United States. 2. University of Minnesota Medical School, Minneapolis, MN, United States. Clinical Research: Epidemiology and Observational Research