Acellular Fish Skin Grafts for Treatment of Periocular Skin Defects.

PURPOSE: To describe the outcomes of acellular fish skin grafts for repair of periocular anterior lamella skin defects after Mohs surgery for skin cancers. METHODS: Following the institutional review board approval, we conducted a retrospective chart review of patients treated with acellular fish skin grafts between January 2022 and December 2023. Indication was to repair defects after Mohs excision of basal cell carcinoma and squamous cell carcinoma. Demographics, smoking and diabetes status, diagnosis, defect location, graft size, and complications were evaluated. Outcomes were analyzed using the scar cosmesis assessment and rating scale. RESULTS: Six patients (3 females and 3 males) with a mean age of 60.8 (range 44-80) had Mohs surgery for basal cell carcinoma (4) and squamous cell carcinoma (2). Location of defects included eyebrow (3 cases), lateral nasal wall (1 case), lower eyelid (1 case), and medial lower eyelid/nasal wall (1 case). Defect size ranged from 8 × 10 mm to 30 × 40 mm. Two patients had more than 1 application of xenograft. One patient developed a mild cicatricial ectropion. No other postoperative complications were seen, and all had good wound healing and cosmetically acceptable results. CONCLUSIONS: In this pilot study, acellular fish skin xenografts are shown to be promising skin graft substitutes in patients with Mohs defects and decrease the need for autologous skin harvesting or allogenic skin donation.

Using infodemiology metrics to assess patient demand for oculoplastic surgeons in the United States: insights from Google Search Trends.

PURPOSE: The aim of this study was to compare state-by-state concentrations of oculoplastic surgeons against patient demand using Google Search Trends data, in order to identify potential areas of unmet need. METHODS: Google Trends data from 2004 to 2019 was collected to determine relative search volumes for the keyword "blepharoplasty" in each US state and the District of Columbia. Oculoplastic surgeon density was calculated by dividing the number of active American Society of Plastic and Reconstructive Surgeons members in 2019 by the State Census Bureau population estimates. Relative search volume values were divided by the local concentration of surgeons, and results were normalized between 0 and 100 to obtain a relative demand index for each state. RESULTS: Oculoplastic surgeon density varied widely across the country. The greatest concentrations of surgeons per 100,000 people were in D.C. (0.708) and Rhode Island (0.378), while the lowest were in Montana, New Mexico, North Dakota, South Dakota, and Wyoming (all 0). Relative search volumes were tightly distributed, ranging between 100 (Hawaii) and 45 (Vermont). The highest relative demand was found in low surgeon density states, such as Hawaii, Montana, New Mexico, North Dakota, South Dakota, and Wyoming. The lowest relative demand was found in DC (5), Rhode Island (12), and Utah (12). CONCLUSIONS: Our results revealed vast disparities in surgical concentrations across the US and highlighted a number of areas with a relative undersupply of oculoplastic surgeons. Further investigation is necessary to examine the underlying factors impacting the supply and distribution of oculoplastic surgeons.