Length-to-width ratio in Mohs defects: what is the golden rule?

A length-to-width ratio (LWR) of 3:1 for linear closures is often cited in the literature. However, there are limited studies evaluating this ratio in relation to various surgical sites. This study analyzes LWRs for 3318 patients undergoing Mohs micrographic surgery (MMS) and linear repair to identify the average LWRs stratified by patient age, anatomic location, gender, and surgeon. Average LWRs ranged between 2.89 and 3.82. The LWR for all anatomic sites averaged between 3:1 and 4:1, except for closures on the trunk. Locations with the highest LWR included the cheek, ear, and perioral sites.