It is becoming increasingly more common for dermatology patients to present for treatment of multiple skin cancers during the same appointment. When 2 lesions are close together, the final repair will need to take into consideration the final size of the adjacent defects, any normal tissue remaining between the defects, and the inherent tension of the tissue in those locations. The SUTUREGARD ISR device (Sutureguard Medical Inc) can allow intraoperative tissue expansion to decrease tension on

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... e tissue and may provide the opportunity to allow primary linear closure for both defects as opposed to a much larger flap or graft repair.