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Comparison of negative pressure wound therapy and secondary intention healing after excision of acral lentiginous melanoma on the foot
Author(s) -
Oh B.H.,
Lee S.H.,
Nam K. A.,
Lee H.B.,
Chung K.Y.
Publication year - 2013
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.12099
Subject(s) - medicine , acral lentiginous melanoma , vascularity , negative pressure wound therapy , surgery , wound healing , scars , melanoma , foot (prosody) , dermatology , pathology , linguistics , philosophy , alternative medicine , cancer research
Summary Background Melanoma in dark‐skinned individuals often develops in an acral lentiginous fashion on the foot and wide excision usually results in a substantial defect. Various repair methods, including free flap, full‐thickness skin graft and secondary intention healing (SIH), are used to repair these defects. Recently, use of negative pressure wound treatment (NPWT) has been shown to accelerate wound healing in different types of wound. Objectives To compare the functional and cosmetic results of NPWT and SIH in patients who underwent wide excision of melanomas on the foot. Methods The wound defects of 22 patients after wide excision of melanoma on the foot were treated using SIH ( n = 13) or NPWT ( n = 9). Results There was no significant difference in time to complete wound healing between the two groups. However, evaluation using the Vancouver Burn Scar Assessment Scale at the time of complete healing showed that the mean score of the NPWT group was significantly lower than that of the SIH group. The NPWT group also had significantly better results than the SIH group in terms of total score, vascularity and height of the scars. As for complications, no wound infection was encountered in the NPWT group, whereas eight of the 13 patients in SIH group had wound infections during the course of treatment despite frequent and meticulous aseptic dressing changes. Conclusions These results show that, despite the drawback of rather prolonged healing time, NPWT is an excellent therapeutic option for wounds after wide excision of melanoma on the foot, with acceptable functional and cosmetic outcomes.