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Reconstruction of large wounds using a combination of negative pressure wound therapy and punch grafting after excision of acral lentiginous melanoma on the foot

Authors
 Jimyung SEO  ;  Jihee KIM  ;  Kyoung Ae NAM  ;  Zhenlong ZHENG  ;  Byung Ho OH  ;  Kee Yang CHUNG 
Citation
 JOURNAL OF DERMATOLOGY, Vol.43(1) : 79-84, 2015 
Journal Title
 JOURNAL OF DERMATOLOGY 
ISSN
 0385-2407 
Issue Date
2015
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Foot ; Humans ; Male ; Melanoma/surgery ; Melanoma/therapy* ; Middle Aged ; Negative-Pressure Wound Therapy ; Retrospective Studies ; Skin Neoplasms/surgery ; Skin Neoplasms/therapy* ; Skin Transplantation ; Wound Healing
Keywords
acral lentiginous melanoma ; negative pressure wound therapy ; punch grafting ; reconstruction ; wounds on the feet
Abstract
Melanoma in darker-pigmented individuals often develops in an acral lentiginous fashion on the foot. After surgical removal of a tumor at this site, repair of the wound can be challenging. This is because there is an insufficient local skin pool and lack of mobility of the skin in this area. Moreover, functional aspects such as walking and weight bearing should be considered. We performed a combination treatment of negative pressure wound therapy (NPWT) and punch grafting on 15 patients, after wide excision of acral lentiginous melanomas on the foot, and compared these to 26 patients who underwent either secondary intention healing (SIH, n = 13) or NPWT (n = 13) alone. The punch grafting with NPWT group showed significantly shorter healing times than those of the other two groups. Evaluation of completely healed wounds using the Vancouver Burn Scar Assessment Scale revealed that the punch grafting group had mean values better, or comparable, to the SIH or NPWT group in four of the five scales (except pigmentation). As for complications, only one patient developed a wound infection after punch grafting. Further, by utilizing NPWT for fixation of punch grafts, it was possible to treat all subjects as outpatients after punch grafting. These results show that a combination treatment of NPWT and punch grafting is an excellent therapeutic option for post-wide excision wounds on the feet, with significantly shortened healing times and favorable cosmetic outcomes.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/1346-8138.13017/abstract
DOI
10.1111/1346-8138.13017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Jihee(김지희) ORCID logo https://orcid.org/0000-0002-0047-5941
Seo, Jimyung(서지명)
Oh, Byung Ho(오병호) ORCID logo https://orcid.org/0000-0001-9575-5665
Chung, Kee Yang(정기양) ORCID logo https://orcid.org/0000-0003-3257-0297
Zheng, Zhen Long(정진룡)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/156912
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