Original Article
Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases
Guilherme Canho Bittnera,b,
, Elisa Mayumi Kuboc, Bruno de Carvalho Fantinid, Felipe Bochnia Cercie,f,g
Corresponding author
a Dermatology Service, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
b Private Practice, Campo Grande, MS, Brazil
c Private Practice, Porto União, PR, Brazil
d Dermatology Service, Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil
e Dermatology Service, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
f Postgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paraná, Curitiba, PR, Brazil
g Private Practice, Curitiba, PR, Brazil
Read
6861
Timeswas read the article
2814
Total PDF
4047
Total HTML
Share statistics
array:24 [ "pii" => "S0365059621001173" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.12.008" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "377" "copyright" => "Sociedade Brasileira de Dermatologia" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "pt" => array:19 [ "pii" => "S2666275221001181" "issn" => "26662752" "doi" => "10.1016/j.abdp.2020.12.008" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "377" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "pt" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>" "titulo" => "Reconstrução auricular após cirurgia micrográfica de Mohs: análise de 101 casos" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "408" "paginaFinal" => "415" ] ] "contieneResumen" => array:1 [ "pt" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0040" "etiqueta" => "Figura 8" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr8.jpeg" "Alto" => 1075 "Ancho" => 3175 "Tamanyo" => 391527 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Retalho de transposição pré‐auricular para raiz da hélice. (A). Ferida operatória envolvendo raiz da hélice com perda de cartilagem. (B), Desenho do retalho. (C), Movimento do retalho. (D), Pós‐operatório de dois meses.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Guilherme Canho Bittner, Elisa Mayumi Kubo, Bruno de Carvalho Fantini, Felipe Bochnia Cerci" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Guilherme Canho" "apellidos" => "Bittner" ] 1 => array:2 [ "nombre" => "Elisa Mayumi" "apellidos" => "Kubo" ] 2 => array:2 [ "nombre" => "Bruno de Carvalho" "apellidos" => "Fantini" ] 3 => array:2 [ "nombre" => "Felipe Bochnia" "apellidos" => "Cerci" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059621001173" "doi" => "10.1016/j.abd.2020.12.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621001173?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001181?idApp=UINPBA00008Z" "url" => "/26662752/0000009600000004/v1_202107170646/S2666275221001181/v1_202107170646/pt/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0365059621001240" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.11.007" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "384" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Enhanced serum interferon-lambda 1/interleukin-29 levels in patients with psoriasis vulgaris" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "416" "paginaFinal" => "421" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2928 "Ancho" => 2500 "Tamanyo" => 185471 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A–C) IL-29 induced IL-6, IL-17 and TNF-α mRNA expression in PBMCs from PV patients. PBMCs obtained from 10 PV patients were treated with IL-29 100 ng/mL or PBS for 6 h. After that, mRNA expression of IL-6, IL-17 and TNF-α in PBMCs were measured by Real-time quantitative PCR. IL-29 obviously enhanced IL-6, IL-17 and TNF-α mRNA expression in PBMCs; p-values are based on <span class="elsevierStyleItalic">t-</span>test. n = 10, *p < 0.05, **p < 0.01, compared with control group. (D–E) IL-29 enhanced IL-6 and IL-8 mRNA expression in HaCat cells. HaCaT cells were treated with recombinant IL-29 (1 ng/mL, 10 ng/mL, 100 ng/mL, 1000 ng/mL) or TNF-α (10 ng/mL) for 2 h. After that, mRNA expression of IL-6 and IL-8 in HaCat cells was measured by Real-time quantitative PCR. IL-29 obviously enhanced IL-6 and IL-8 mRNA in HaCat cells; p-values are based on the One-way analysis of variance. n = 10, *p < 0.05, **p < 0.01, compared with control group. All data are expressed as mean ± SD.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Li-xin Fu, Tao Chen, Zai-Pei Guo, Na Cao, Li-Wen Zhang, Pei-Mei Zhou" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Li-xin" "apellidos" => "Fu" ] 1 => array:2 [ "nombre" => "Tao" "apellidos" => "Chen" ] 2 => array:2 [ "nombre" => "Zai-Pei" "apellidos" => "Guo" ] 3 => array:2 [ "nombre" => "Na" "apellidos" => "Cao" ] 4 => array:2 [ "nombre" => "Li-Wen" "apellidos" => "Zhang" ] 5 => array:2 [ "nombre" => "Pei-Mei" "apellidos" => "Zhou" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275221001259" "doi" => "10.1016/j.abdp.2020.11.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001259?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621001240?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000004/v4_202107160617/S0365059621001240/v4_202107160617/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0365059621000805" "issn" => "03650596" "doi" => "10.1016/j.abd.2021.03.001" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "361" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Continuing Medical Education</span>" "titulo" => "Phototherapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "397" "paginaFinal" => "407" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Norami de Moura Barros, Lissiê Lunardi Sbroglio, Maria de Oliveira Buffara, Jessica Lana Conceição e Silva Baka, Allen de Souza Pessoa, Luna Azulay-Abulafia" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Norami de Moura" "apellidos" => "Barros" ] 1 => array:2 [ "nombre" => "Lissiê Lunardi" "apellidos" => "Sbroglio" ] 2 => array:2 [ "nombre" => "Maria de Oliveira" "apellidos" => "Buffara" ] 3 => array:2 [ "nombre" => "Jessica Lana Conceição e Silva" "apellidos" => "Baka" ] 4 => array:2 [ "nombre" => "Allen de Souza" "apellidos" => "Pessoa" ] 5 => array:2 [ "nombre" => "Luna" "apellidos" => "Azulay-Abulafia" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275221001016" "doi" => "10.1016/j.abdp.2021.04.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001016?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621000805?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000004/v4_202107160617/S0365059621000805/v4_202107160617/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "408" "paginaFinal" => "415" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Guilherme Canho Bittner, Elisa Mayumi Kubo, Bruno de Carvalho Fantini, Felipe Bochnia Cerci" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Guilherme Canho" "apellidos" => "Bittner" "email" => array:1 [ 0 => "clinicahans@outlook.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Elisa Mayumi" "apellidos" => "Kubo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Bruno de Carvalho" "apellidos" => "Fantini" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 3 => array:3 [ "nombre" => "Felipe Bochnia" "apellidos" => "Cerci" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] ] "afiliaciones" => array:7 [ 0 => array:3 [ "entidad" => "Dermatology Service, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Private Practice, Campo Grande, MS, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Private Practice, Porto União, PR, Brazil" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Dermatology Service, Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Dermatology Service, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Postgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paraná, Curitiba, PR, Brazil" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Private Practice, Curitiba, PR, Brazil" "etiqueta" => "g" "identificador" => "aff0035" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1517 "Ancho" => 3175 "Tamanyo" => 555646 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Interpolation flap from the mastoid area. (A), Surgical defect involving multiple subunits, with significant loss of cartilage. (B), Detached interpolation flap. The lower incision was performed to harvest the cartilage graft from the concha (white arrow). (C), Sutured cartilage graft (2.5 × 1 cm) (white arrow). (D), Immediate postoperative period. A small skin graft was used for the lower portion of the wound. A small area in the scaphoid fossa was allowed to heal by second intention. (E), Immediate postoperative period of the second surgery (pedicle division), performed 3 weeks later. (F), One-year postoperative period. Cartilage replacement was essential to prevent contraction of the ear.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The ear is a region that has a high prevalence of cutaneous carcinomas.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Due to its aesthetic and functional importance, it is essential to offer patients treatments with less chance of recurrence. For this reason, several guidelines indicate Mohs micrographic surgery (MMS) as the first-choice treatment for cutaneous carcinomas at this site.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a> MMS has the highest cure rates in the treatment of <span class="elsevierStyleItalic">cutaneous</span><span class="elsevierStyleItalic">carcinomas</span>, as it evaluates 100% of the surgical margins, whereas the wide local excision technique assesses about 1% of the margins by “bread-load” sectioning.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Although MMS allows maximum preservation of healthy tissue, many auricular surgical wounds are a challenge due to the peculiar local anatomy, with evident curves and reliefs. Auricular reconstruction should prioritize function before aesthetics, but without leaving the latter aside, since postoperative distortions can have a significant psychological impact.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> It is important to mention that the ear is essential for the support of prescription glasses and the “fitting” of hearing aids, especially in elderly patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">For the repair of auricular surgical wounds, one must take into account their diameter and depth, availability of adjacent skin, cartilage involvement, use of hearing aids, dependence on prescription glasses, and patient expectations.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a> There are several available options, including healing by secondary intention, primary closure, skin grafts, cartilage grafts, flaps, or a combination of them.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of the study was to describe the authors’ experience in auricular reconstruction after MMS and to evaluate the most frequently used repair methods.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This was a retrospective study of consecutive cases submitted to MMS and auricular reconstruction by the authors, between January 2017 and July 2020. The cases are from the authors’ private practices and from a university hospital where one of the authors works. The study was approved by the Ethics Committee, protocol number 30746120.4.0000.0103.</p><p id="par0030" class="elsevierStylePara elsevierViewall">With the exception of one surgery performed under local anesthesia and sedation, all were performed under local anesthesia. Postoperatively, antibiotics (cephalexin 500 mg, every 6 h for 7 days or cefadroxil 500 mg, every 12 h for 4 days) were used in more complex, long-term surgeries or when cartilage was removed.</p><p id="par0035" class="elsevierStylePara elsevierViewall">For data analysis, a review of the photographic documentation and the following data were performed: age, sex, Fitzpatrick phototype, tumor characteristics, defect size and involved anatomical subunits, number of MMS stages, type of reconstruction performed, use of platelet antiaggregants or anticoagulants and postoperative complications.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The auricular subunits were divided into crus helix, helix, anti-helix, concha, tragus, antitragus, scapha, lobule, the auditory canal and posterior region of the ear (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The reconstruction methods were divided into healing by second intention, primary closure, flaps or graft. When more than one method was used, it was called a combined reconstruction. For the analysis of repair methods, only repairs used for the closure of auricular subunits were considered.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Complications were divided into two groups, short and long-term ones. The following were considered short-term: bleeding that required reintervention, hematoma, infection, dehiscence, and flap/graft necrosis (partial or total). Long-term ones were defined as considerable anatomical distortions and chondritis.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">A total of 101 cases of 90 patients were included in the study. In 99 cases, the surgical wounds were reconstructed by the dermatologists themselves after the end of the MMS. Demographic and surgical data are described in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. The mean size of the tumors was 11.7 × 9.4 mm, with 87 primary, 11 recurrent and 3 incompletely excised tumors. Fourteen patients were on acetylsalicylic acid, two on rivaroxaban, and one on clopidogrel.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The primarily affected auricular subunits were the helix (n = 38), followed by the antihelix (17), concha (12), posterior ear surface (11), tragus (7), crus helix (5), lobule (5), fossa triangularis (2), scapha (2), antitragus (1) and the auditory canal (1). In 77 cases, only one subunit was affected and in 24 cases, more than one subunit was involved. The combination of reconstruction methods was used in 18.2% of cases with the involvement of one subunit and 62.5% of cases with the involvement of more than one subunit.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The most frequently used reconstruction methods were: primary closure (n = 35) and skin graft (n = 30). In four cases, cartilage grafting was performed concomitantly with the interpolation flap. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the reconstructions performed according to the involved auricular subunit. For the helix, tragus and posterior surface of the ear, the primary closure was the most frequently performed; for the antihelix, full-thickness skin graft; for the crus helix, flaps and, for the concha, healing by second intention.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Regarding the flaps, in 24 cases, they were the main reconstruction method: interpolation (n = 5), pull through (n = 5), transposition (n = 5), advancement (n = 4), rotation (n = 3) and island pedicle (n = 2). There was a combination of reconstruction methods in 30 cases. Two patients were referred by plastic surgery to undergo MMS and, after its completion, returned for reconstruction with the plastic surgeon. One was repaired using primary closure and the other with an advancement flap.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Pre- and postoperative prophylactic antibiotics were used in 12 and 44 cases, respectively. Complications occurred in 6.93% (n = 7) of the cases, all were short-term. The most common complications were partial graft necrosis (n = 5) and bleeding (n = 2), none was life-threatening. There was one case of local infection (associated with graft necrosis), which was treated with oral antibiotics with adequate resolution. Partial flap or graft necrosis were managed with local wound care, without significant long-term damage.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">The present study demonstrated the variety of reconstruction options available for the auricular region, in addition to the frequent use of flaps and grafts, similarly to previous publications.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,11</span></a> It also demonstrated that, differently from the nasal area, the auricular region allows the reconstruction of several anatomical subunits with the same method, either by a flap or graft, without aesthetic prejudice to the patient.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The mean number of stages for complete tumor resection was 1.4. A possible explanation for the relatively small number of stages was the dermoscopic examination in the preoperative period, associated with a high number of primary cases in the present study.</p><p id="par0085" class="elsevierStylePara elsevierViewall">It is interesting to note that 10% of patients (n = 9) had concomitant tumors in the auricular region, representing 19.8% (n = 20) of all lesions. Despite the small number, the hypothesis that patients with cutaneous carcinomas in the ear are at greater risk of having a new lesion in the same anatomical region can be suggested. This number may be even higher if we take into account that other patients may seek treatment from other professionals.</p><p id="par0090" class="elsevierStylePara elsevierViewall">The choice of repair methods varied according to the location and extent of the surgical defect, with primary closure being the most frequently used (n = 35). This reconstruction method showed to be valuable, mainly for small-extension lesions, and in 80% of primary closure cases, surgical defects had up to 13 mm in their largest extension. In the remaining 20%, the wounds were located in more mobile subunits, such as the lobule and posterior ear surface.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The second most frequently repair was full-thickness skin graft (n = 30). This method was implemented in several subunits (helix, crus helix, scapha, antihelix, concha, fossa triangularis, and posterior ear surface), for wounds of variable sizes, however, that did not have significant loss of contour or cartilaginous structure of the ear. Defects with cartilage loss can be restored with a skin graft, ideally if the ear cartilaginous structural support is maintained, to preserve its contour and function (support for glasses, for example) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The interpolation flap from the mastoid area, a reconstruction option for extensive defects (mean size of 36.4 × 26.8 mm), was used mainly when there was concomitant involvement of the helix, scapha and antihelix (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). In all cases, the wounds were full-thickness and, in 4 cases, they were associated with cartilage graft to maintain or restore the auricular contour. The cartilage grafts were obtained from the ipsilateral concha (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). In one case, the interpolation flap was used to repair the lobule (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). Despite the need for two surgeries for its completion, this flap allows repairing extensive auricular wounds, even full-thickness ones.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12,13</span></a></p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The pull-through flap was used mainly to repair the concha and antihelix subunits. Larger and deeper surgical wounds in these areas might not have the skin graft as the best indication, due to the increased risk of necrosis, especially if the perichondrium has been removed. In the pull-through flap, the skin of the mastoid region in the form of a “saloon door” flap is used for the complete closure of the wound (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>).<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> This flap is performed in a single stage, therefore a new approach is not necessary after three weeks. Compared to second-intention healing, an excellent option for the concha, the advantage of this flap is the immediate repair of the wound, which shortens and minimizes postoperative care.</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Second-intention healing was chosen for defects in concave areas (concha, scapha, fossa triangularis, and auditory canal) and superficial wounds of the anti-helix and posterior region with preserved perichondrium. When the latter is involved, the healing takes longer, but it does not contraindicate healing by second intention.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> To optimize this time, 2-mm punches can be made, transfixing the cartilage and allowing the wound to be nourished from the opposite side. This technique can also be associated with skin grafts. Second-intention healing can be combined with other repair methods. In the present study, this occurred in nine cases, as shown in <a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>.</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Traditional flaps such as transposition, advancement, rotation, and island pedicle (V – Y) were used on 14 wounds, all with dimensions >12 mm. The advancement and island advancement flaps were implemented mainly for the helix region, recruiting skin from the posterior and/or inferior portion of the ear. The use of the rotation flaps for full-thickness helical defects is an alternative to the interpolation flap (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>). The transposition flap also showed to be an excellent alternative for anterior portion defects, such as the crus of the antihelix and tragus, as it uses the skin of the pre-auricular region, resulting in a discreet scar in the donor area (<a class="elsevierStyleCrossRef" href="#fig0040">Fig. 8</a>).</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><elsevierMultimedia ident="fig0040"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">The use of prophylactic antibiotics in the pre-and postoperative periods is a controversial topic in dermatologic surgery. Some authors recommend preoperative use when the auricular cartilage is involved, as well when using grafts and flaps on the nasal region.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> In the present study, preoperative antibiotic therapy was indicated in 11.8% and postoperative antibiotics in 43.5% of cases, reflecting the difficulty in anticipating the wound extent and the type of reconstruction to be performed.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The performance of the procedures with local anesthesia and vasoconstrictors (100 cases) in the outpatient setting (95 cases) did not show an increase in risks or complications for the patients, data that have been well established in the literature.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17–21</span></a> With 0.99% of infection and 6.93% of minor complications (bleeding and partial graft necrosis), the authors’ sample reproduces the types of adversities most often described in the literature.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,19</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusion</span><p id="par0130" class="elsevierStylePara elsevierViewall">Although primary closure and grafts correspond to the main methods of auricular repair, the dermatologic surgeon must become familiar with several reconstruction alternatives in this area, aiming at functional preservation and aesthetic restoration. It is essential to reinforce that, as recommended by the National Comprehensive Cancer Network, ideally, reconstructions in cosmetic sensitive areas such as the ear are performed after complete tumor resection, confirmed by analysis of 100% of the surgical margins during surgery, as performed in MMS.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Financial support</span><p id="par0135" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Authors’ contributions</span><p id="par0140" class="elsevierStylePara elsevierViewall">Guilherme Canho Bittner: Participation in the design and planning of the study; collection, analysis, and interpretation of data; writing; approval of the final version of the manuscript.</p><p id="par0145" class="elsevierStylePara elsevierViewall">Elisa Mayumi Kubo: Writing; approval of the final version of the manuscript.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Bruno de Carvalho Fantini: Collection, analysis, and interpretation of data; critical review of the manuscript; approval of the final version of the manuscript.</p><p id="par0155" class="elsevierStylePara elsevierViewall">Felipe Bochnia Cerci: Participation in the design and planning of the study; collection, analysis, and interpretation of data; writing; critical review of the manuscript; approval of the final version of the manuscript.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1550358" "titulo" => "Abstract" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Study limitations" ] 5 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1400145" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Financial support" ] 8 => array:2 [ "identificador" => "sec0035" "titulo" => "Authors’ contributions" ] 9 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-09-30" "fechaAceptado" => "2020-12-05" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1400145" "palabras" => array:4 [ 0 => "Auricular pavilion" 1 => "Ear neoplasms" 2 => "Mohs surgery" 3 => "Surgical flaps" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The ear is a region that has a high prevalence of cutaneous carcinomas and several guidelines indicate Mohs micrographic surgery as the first-choice treatment in such cases. Although the technique allows maximum preservation of healthy tissue, many auricular surgical wounds constitute a challenge due to the peculiar local anatomy, with evident curves and reliefs. Auricular reconstruction should prioritize function before aesthetics, but without leaving the latter aside, since postoperative distortions can have a significant psychological impact.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">To describe the authors’ experience in auricular reconstruction after Mohs surgery and to evaluate the most frequently used repair methods.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of consecutive cases submitted to Mohs surgery and auricular reconstruction, over a period of 3 years.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">One hundred and one cases were included and the most common repair method was primary closure (n = 35), followed by full-thickness skin graft (n = 30) and flaps (n = 24). In thirty cases, reconstruction methods were associated. Seven patients had complications (partial graft necrosis, postoperative bleeding or infection).</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Study limitations</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Retrospective design and the absence of long-term follow-up of some cases.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">The dermatologic surgeon should be familiarized with different options for auricular reconstruction. Primary closure and skin grafts were the most frequently used repair methods.</p></span>" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Study limitations" ] 5 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusions" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar00005">How to cite this article: Bittner GC, Kubo EM, Fantini BC, Cerci FB. Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases. An Bras Dermatol. 2021;96:408–15.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the authors’ Private Practices (Cepelle Dermatologia, Curitiba - PR; Clínica Hans Dermatologia, Campo Grande - MS; Clínica Fantini Dermatologia, Riberão Preto - SP) and Dermatology Service, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.</p>" ] ] "multimedia" => array:10 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2465 "Ancho" => 2341 "Tamanyo" => 366280 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tumor location. * The auditory canal and the tumor located in it are not shown in the picture.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 455 "Ancho" => 1405 "Tamanyo" => 104757 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Full-thickness skin graft for multiple auricular subunits. (A), Poorly delimited basal cell carcinoma. (B), Surgical defect involving the scapha, anti-helix and fossa triangularis with loss of cartilage. (C), Immediate postoperative period. (D), Long-term postoperative.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1517 "Ancho" => 3175 "Tamanyo" => 555646 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Interpolation flap from the mastoid area. (A), Surgical defect involving multiple subunits, with significant loss of cartilage. (B), Detached interpolation flap. The lower incision was performed to harvest the cartilage graft from the concha (white arrow). (C), Sutured cartilage graft (2.5 × 1 cm) (white arrow). (D), Immediate postoperative period. A small skin graft was used for the lower portion of the wound. A small area in the scaphoid fossa was allowed to heal by second intention. (E), Immediate postoperative period of the second surgery (pedicle division), performed 3 weeks later. (F), One-year postoperative period. Cartilage replacement was essential to prevent contraction of the ear.</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 497 "Ancho" => 1405 "Tamanyo" => 132630 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Retroauricular interpolation flap for the lobule. (A), Full-thickness surgical defect. (B), Flap design. (C), One week after the first stage. Note the pedicle at the bottom part of the figure. (D), Three months of postoperative period. Note the adequate repair of the lobule contour and maintenance of the ear size.</p>" ] ] 4 => array:8 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1511 "Ancho" => 3167 "Tamanyo" => 496677 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pull-through flap. (A), Surgical defect involving the concha, with loss of cartilage. (B), Flap design. (C), Detached flap with island pedicle. The white arrow indicates the flap movement. (D), Flap crossing the ear after a small full-thickness incision in the concha. (E), Immediate postoperative period. (F), One year of postoperative period.</p>" ] ] 5 => array:8 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 2133 "Ancho" => 3175 "Tamanyo" => 683648 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">(A and B), Recurrent SCC in the retroauricular sulcus. (C), Surgical defect after the first stage of Mohs surgery. The deep margin was completely affected, even where the cartilage had been removed. (D), Final surgical defect involving the retroauricular area (retroauricular sulcus) and full-thickness of the pavilion (almost the entire anti-helix and fossa triangularis). The helix was preserved. (E), Immediate postoperative period. The pavilion was sutured in the retroauricular/mastoid region. The area of the full-thickness defect healed by second intention. (F), Postoperative. (G and H), After months, at a second moment, the pavilion was detached from the retroauricular region and a full-thickness skin graft (harvested from the supraclavicular region) was performed in the posterior surface of the pavilion. The retroauricular area healed by second intention.</p>" ] ] 6 => array:8 [ "identificador" => "fig0035" "etiqueta" => "Figure 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 1035 "Ancho" => 3175 "Tamanyo" => 333790 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Helix advancement flap. (A), Poorly circumscribed basal cell carcinoma on the right helix. (B), Full-thickness surgical defect with loss of the helix contour. (C), Detached flap. (D), Immediate postoperative period. (E), Long-term postoperative.</p>" ] ] 7 => array:8 [ "identificador" => "fig0040" "etiqueta" => "Figure 8" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr8.jpeg" "Alto" => 1075 "Ancho" => 3175 "Tamanyo" => 391953 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Pre-auricular transposition flap to the crus helix. (A), Surgical defect involving the crus helix with loss of cartilage. (B), Flap design. (C), Flap movement. (D), Eighteen months of postoperative.</p>" ] ] 8 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0045" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age (years) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Phototype \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reconstruction method<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68.9 (mean) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 women \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I:1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Primary closure: 35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 to 92</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 men</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II: 60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Skin graft: 30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III: 29</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Flap: 25 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Second intention: 11 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2657866.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of stages \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tumors \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anesthesia method \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean defect size (mm) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " rowspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 (1 to 4)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 BCCs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Local: 100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.8 × 12.5</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 SCCs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Local + IV sedation: 1</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 SCCs <span class="elsevierStyleItalic">in situ</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 keratoacanthoma \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2657865.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">In this division, only the main method of reconstruction was accounted for. In 33 cases, there was a combination of repair methods, with the most common combination being primary closure with skin graft (n = 14).</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Demographic and surgical data of the 101 surgical cases.</p>" ] ] 9 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0050" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of cases \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Second intention \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Primary closure \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Flap \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Graft \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Helix \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antihelix \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Concha \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Posterior area \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tragus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lobule \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Crus helix \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Scapha \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fossa triangularis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antitragus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Auditory canal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2657867.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Reconstructions performed according to the affected subunits.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Variations of basal cell carcinomas according to gender, age, location and histopathological subtype" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Scrivener" 1 => "E. Grosshans" 2 => "B. Cribier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2133.2002.04804.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2002" "volumen" => "147" "paginaInicial" => "41" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12100183" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for the management of basal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N.R. Telfer" 1 => "G.B. Colver" 2 => "C.A. Morton" 3 => "British Association of D" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2008.08666.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2008" "volumen" => "159" "paginaInicial" => "35" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18593385" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Basal Cell Skin Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.K. Bichakjian" 1 => "T. Olencki" 2 => "S.Z. Aasi" 3 => "M. Alam" 4 => "J.S. Andersen" 5 => "D. Berg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.6004/jnccn.2016.0065" "Revista" => array:6 [ "tituloSerie" => "J Natl Compr Canc Netw" "fecha" => "2016" "volumen" => "14" "paginaInicial" => "574" "paginaFinal" => "597" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27160235" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines of care for the management of basal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Work Group" 1 => "Invited Reviewers" 2 => "J.Y.S. Kim" 3 => "J.H. Kozlow" 4 => "B. Mittal" 5 => "J. Moyer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2017.10.006" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2018" "volumen" => "78" "paginaInicial" => "540" "paginaFinal" => "559" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29331385" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accuracy of serial transverse cross-sections in detecting residual basal cell carcinoma at the surgical margins of an elliptical excision specimen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Kimyai-Asadi" 1 => "L.H. Goldberg" 2 => "M.H. Jih" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2005.02.049" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2005" "volumen" => "53" "paginaInicial" => "469" "paginaFinal" => "474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16112355" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Understanding Mohs Micrographic Surgery: A Review and Practical Guide for the Nondermatologist" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.N. Tolkachjov" 1 => "D.G. Brodland" 2 => "B.M. Coldiron" 3 => "M.J. Fazio" 4 => "G.J. Hruza" 5 => "R.K. Roenigk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mayocp.2017.04.009" "Revista" => array:6 [ "tituloSerie" => "Mayo Clin Proc" "fecha" => "2017" "volumen" => "92" "paginaInicial" => "1261" "paginaFinal" => "1271" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28778259" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Importance of physical appearance in patients with skin cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.F. Sobanko" 1 => "D.B. Sarwer" 2 => "Z. Zvargulis" 3 => "C.J. Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DSS.0000000000000253" "Revista" => array:6 [ "tituloSerie" => "Dermatol Surg" "fecha" => "2015" "volumen" => "41" "paginaInicial" => "183" "paginaFinal" => "188" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25654193" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The forehead flap for nasal reconstruction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.M. Boyd" 1 => "S.R. Baker" 2 => "D.J. Fader" 3 => "T.S. Wang" 4 => "T.M. Johnson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.136.11.1365" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2000" "volumen" => "136" "paginaInicial" => "1365" "paginaFinal" => "1370" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11074699" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient Concerns About Nasal Reconstruction After Mohs Surgery and Implications for Shared Decision Making" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.J. Chi" 1 => "A. Rosenberg" 2 => "S. Hahn" 3 => "J.F. Piccirillo" 4 => "M. Politi" 5 => "D. Kallogjeri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamaoto.2018.2368" "Revista" => array:6 [ "tituloSerie" => "JAMA Otolaryngol Head Neck Surg" "fecha" => "2018" "volumen" => "144" "paginaInicial" => "1180" "paginaFinal" => "1181" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30267057" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ear Reconstruction after Mohs Cancer Excision: Lessons Learned from 327 Consecutive Cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Sanniec" 1 => "M. Harirah" 2 => "J.F. Thornton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PRS.0000000000005992" "Revista" => array:6 [ "tituloSerie" => "Plast Reconstr Surg" "fecha" => "2019" "volumen" => "144" "paginaInicial" => "719" "paginaFinal" => "729" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31461038" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reconstruction of the Ear" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.M. Smith" 1 => "P.J. Byrne" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.fsc.2018.08.010" "Revista" => array:6 [ "tituloSerie" => "Facial Plast Surg Clin North Am" "fecha" => "2019" "volumen" => "27" "paginaInicial" => "95" "paginaFinal" => "104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30420076" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staged retroauricular flap for helical reconstruction after Mohs micrographic surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F.B. Cerci" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/abd1806-4841.20164733" "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2016" "volumen" => "91" "paginaInicial" => "144" "paginaFinal" => "147" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28300924" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staged cheek-to-nose and auricular interpolation flaps" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T.H. Nguyen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1524-4725.2005.31828" "Revista" => array:6 [ "tituloSerie" => "Dermatol Surg" "fecha" => "2005" "volumen" => "31" "paginaInicial" => "1034" "paginaFinal" => "1045" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16042927" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pull-through subcutaneous pedicle flap for an anterior auricular defect" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.H. Nguyen" 1 => "J.S. Bordeaux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1524-4725.2010.01575.x" "Revista" => array:6 [ "tituloSerie" => "Dermatol Surg" "fecha" => "2010" "volumen" => "36" "paginaInicial" => "945" "paginaFinal" => "949" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20482730" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Healing by secondary intention of auricular defects after Mohs surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.C. Levin" 1 => "L.A. Adams" 2 => "G.D. Becker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archotol.1996.01890130051008" "Revista" => array:6 [ "tituloSerie" => "Arch Otolaryngol Head Neck Surg" "fecha" => "1996" "volumen" => "122" "paginaInicial" => "59" "paginaFinal" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8554748" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.I. Wright" 1 => "L.M. Baddour" 2 => "E.F. Berbari" 3 => "R.K. Roenigk" 4 => "P.K. Phillips" 5 => "M.A. Jacobs" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2008.04.031" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2008" "volumen" => "59" "paginaInicial" => "464" "paginaFinal" => "473" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18694679" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety of Local Intracutaneous Lidocaine Anesthesia Used by Dermatologic Surgeons for Skin Cancer Excision and Postcancer Reconstruction: Quantification of Standard Injection Volumes and Adverse Event Rates" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Alam" 1 => "M.R. Schaeffer" 2 => "A. Geisler" 3 => "E. Poon" 4 => "S.W. Fosko" 5 => "D. Srivastava" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DSS.0000000000000907" "Revista" => array:6 [ "tituloSerie" => "Dermatol Surg" "fecha" => "2016" "volumen" => "42" "paginaInicial" => "1320" "paginaFinal" => "1324" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27893492" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The safety of Mohs surgery: a prospective multicenter cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B.G. Merritt" 1 => "N.Y. Lee" 2 => "D.G. Brodland" 3 => "J.A. Zitelli" 4 => "J. Cook" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2012.05.041" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2012" "volumen" => "67" "paginaInicial" => "1302" "paginaFinal" => "1309" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22892283" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adverse events associated with mohs micrographic surgery: multicenter prospective cohort study of 20,821 cases at 23 centers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Alam" 1 => "O. Ibrahim" 2 => "M. Nodzenski" 3 => "J.M. Strasswimmer" 4 => "S.I.B. Jiang" 5 => "J.L. Cohen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "JAMA Dermatol" "fecha" => "2013" "volumen" => "149" "paginaInicial" => "1378" "paginaFinal" => "1385" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The incidence of major complications from Mohs micrographic surgery performed in office-based and hospital-based settings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Kimyai-Asadi" 1 => "L.H. Goldberg" 2 => "S.R. Peterson" 3 => "S. Silapint" 4 => "M.H. Jih" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2005.03.023" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2005" "volumen" => "53" "paginaInicial" => "628" "paginaFinal" => "634" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16198783" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety of local anesthetics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.C.F.P. Cherobin" 1 => "G.T. Tavares" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.abd.2019.09.025" "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2020" "volumen" => "95" "paginaInicial" => "82" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31952994" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009600000004/v4_202107160617/S0365059621001173/v4_202107160617/en/main.assets" "Apartado" => array:4 [ "identificador" => "89516" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009600000004/v4_202107160617/S0365059621001173/v4_202107160617/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621001173?idApp=UINPBA00008Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 19 | 7 | 26 |
| 2024 October | 124 | 66 | 190 |
| 2024 September | 205 | 83 | 288 |
| 2024 August | 219 | 115 | 334 |
| 2024 July | 199 | 109 | 308 |
| 2024 June | 144 | 69 | 213 |
| 2024 May | 109 | 78 | 187 |
| 2024 April | 100 | 101 | 201 |
| 2024 March | 91 | 88 | 179 |
| 2024 February | 110 | 93 | 203 |
| 2024 January | 90 | 78 | 168 |
| 2023 December | 73 | 65 | 138 |
| 2023 November | 91 | 85 | 176 |
| 2023 October | 91 | 92 | 183 |
| 2023 September | 89 | 77 | 166 |
| 2023 August | 83 | 39 | 122 |
| 2023 July | 117 | 46 | 163 |
| 2023 June | 82 | 51 | 133 |
| 2023 May | 98 | 38 | 136 |
| 2023 April | 79 | 27 | 106 |
| 2023 March | 118 | 50 | 168 |
| 2023 February | 100 | 38 | 138 |
| 2023 January | 70 | 54 | 124 |
| 2022 December | 79 | 44 | 123 |
| 2022 November | 132 | 63 | 195 |
| 2022 October | 126 | 56 | 182 |
| 2022 September | 75 | 71 | 146 |
| 2022 August | 59 | 55 | 114 |
| 2022 July | 38 | 59 | 97 |
| 2022 June | 55 | 54 | 109 |
| 2022 May | 48 | 53 | 101 |
| 2022 April | 68 | 52 | 120 |
| 2022 March | 63 | 65 | 128 |
| 2022 February | 69 | 41 | 110 |
| 2022 January | 83 | 90 | 173 |
| 2021 December | 55 | 78 | 133 |
| 2021 November | 64 | 62 | 126 |
| 2021 October | 55 | 72 | 127 |
| 2021 September | 82 | 83 | 165 |
| 2021 August | 101 | 89 | 190 |
| 2021 July | 242 | 109 | 351 |
| 2021 June | 52 | 69 | 121 |
Show all
