Comparison of Secondary Intention Healing and Full-Thickness Skin Graft After Excision of Acral Lentiginous Melanoma on Foot

Abstract

Secondary intention healing after excision of melanoma from the foot is a therapeutic option with acceptable functional and cosmetic outcomes.

Full-Thickness Skin Grafts for Lower Leg Defects

“…In this study, time to 90% graft healing was 30 days in 88% of the FTSG patients compared with time to complete reepithelialization of 12 weeks in a study of patients who underwent SIH after wide excision of melanoma on the foot. 3 However, the different anatomic sites (lower limb vs sole of foot), the different outcome measures used (90% graft healing compared with complete reepithelialization), and the distinct patient cohorts in the 2 studies are significant factors that could explain, in part, the differences in healing time. However, SIH showed better functional and cosmetic outcomes in comparison with FTSG as graded by patient and independent scoring systems in the study by Jung and colleagues.…”

“…The FTSG group showed more rapid healing than SIH (8 vs 12 weeks), but the SIH group showed better cosmetic and functional outcomes. 3 Local flap repair for lower leg defects maintains 1 surgical wound site. The keystone-design fasciocutaneous island flap is an example of a local flap repair.…”

“…The keystone-design fasciocutaneous island flap is an example of a local flap repair. 3 Keystone flap reconstruction of primary melanoma excision defects of the lower limb has been shown to be reliable, produce good cosmetic results, and is technically straightforward to perform. 4 However, local flap repair can still be difficult to achieve, especially in the elderly patient with poor skin quality.…”

Current Surgical Management of Acral Lentiginous Melanoma

“…The sole has weight-bearing areas such as the heel. In addition, a defect on the foot may result in insufficient vascular flow [54].…”

“…According to previous reports, it took approximately 12-18 weeks to close the defects (mean defect size: 32.6-36.5 cm 2 ) [54,59]. Despite these drawbacks, it has the advantages of avoiding a secondary wound for tissue harvesting, a smaller scar because of the natural contraction of the wound, and granulation tissue that acts as a cushion to absorb impact while walking [54]. Recently, the effect of negative pressure wound therapy in addition to secondary intention healing has been investigated [59].…”