Effectiveness and Safety of X A-DERM™ Microsurfaced Acellular Dermal Matrix for Wound Healing After MOHS Surgery

This will be done by capturing digital photographs. Digital photographs of the wound bed site will be acquired pre- and post-placement of the mADM perioperatively and at follow-up visits.

This will be done by requesting patients and clinicians to complete POSAS assessments, the Patient and Observer Scar Assessment Scale. The POSAS contains two assessments. The first assessment captures patients' views on scar pain, itchiness, if the scar color is different, if the scar is more stiff, is the thickness of the scar different, and is the scar irregular by ranking their answer from a scale of 1-10. 1 being "no, no complaints" and 10 being "yes, worst imaginable". The second assessment is the clinician's portion. It involves objective scoring based on standardized criteria for characteristics such as vascularity, pigmentation, thickness, relief, pliability, and surface area using a scale from 1-10 1 being "Normal skin" and 10 being "worst scar imaginable".

This will be done by completing clinician reported outcomes. The first clinician reported outcome tool used is the Visual Analog Scale (VAS) for scar appearance. It is completed by making a mark across the line corresponding to the clinician observation between the statements at each of the extremes. The associated "lines" encapsulate a spectrum of scar appearance with "excellent" on one end and "poor" on the opposite.

This will be done by completing clinician reported outcomes. The second clinician reported outcome tool used is the Manchester Scar Satisfaction Scale (MSSS). It is completed by the clinician evaluating the patient's scar by checking the box of the corresponding characteristic that best matches their assessment for 5 parameters. The first parameter is color (compared to surrounding skin), and the options are perfect, slight mismatch, obvious mismatch, and gross mismatch. The second matte or shiny, and those are the two options. The third is contour, the options being flush with surrounding area, slightly proud (indented), hypertrophic, and keloid. The fourth is distortion with options of none, mild, moderate, and severe. The last parameter is texture with options of normal, just palpable, firm, and hard.

This will be done by completing patient reported outcomes. The first patient reported outcome tool used is the Visual Analog Scale (VAS) for pain intensity, itching intensity, and cosmetic appearance. It is completed by the patient making a mark across the line corresponding to their observation between the statements at each of the extremes. The associated "lines" encapsulate a spectrum of pain intensity ("no pain" and "worst pain imaginable"), itching intensity ("no itch" and "worst itch imaginable"), and cosmetic appearance ("worst scar" and "best scar").

This will be done by completing patient reported outcomes. The second patient reported outcome tool used is the ease of wound care numerical rating scale (NRS). The patient reports on a scale from 0 to 10, where 0 represents "Very Easy" and 10 represents "Impossible," please rate how easy it was for them to care for the wound by themself?

This will be done by completing patient reported outcomes. The third patient reported outcome tool used is the Skindex-16 questionnaire. The patient will for each of the following questions, make a mark in the box corresponding to your feelings about each of the statements. The scale is "never bothered" to "always bothered" on a 0-6 numerical rank and the various conditions are as follows: itching, burning or stinging, hurting, your skin condition being irritated, the persistence/reoccurrence of your skin condition, worry about your skin condition, the appearance, frustration, embarrassment, being annoyed about your skin condition, feeling depressed about your skin condition, the effects of your skin condition on your desire to be with people, your skin condition making it hard to show affection, the effects of your skin condition on your daily activities, and your skin condition making it hard to work or do what you enjoy.