Dermatopathology and Skin Cancer

This chapter aims to divide complications from dermatopathology and skin cancer management into two broad categories: early and late complications. It discusses various complications specific to common reconstructive modalities that include skin grafting, local flaps, and pedicled flaps. Hematomas may compromise local flap perfusion by inducing vasospasm, stretching the subdermal vascularity, or separating the flap from the surface of the recipient site. Surgical site infection (SSI) is a common complication that may occur with any surgical procedure. The key to preventing flap necrosis starts with proper flap design. SSI or hematoma may also compromise flap perfusion by decreasing the perfusion pressure gradient along with the release of free radicals that exaggerate flap necrosis. Wound dehiscence occurs most commonly in the early postoperative period. Hyperpigmentation can ensue after healing of skin grafts or local flaps and can be managed with multiple dermabrasion cycles until reaching good results.