Comparison of secondary intention healing and full-thickness skin graft after excision of acral lentiginous melanoma on foot

Abstract

BACKGROUND : Melanoma in dark-skinned individuals often develops in an acral lentiginous fashion on the foot. After wide excision, substantial defects usually develop and they may endure insufficient vascular flow. In addition, the final scar must withstand the mechanical stress of daily walking. Various repair methods are used to repair these defects, but secondary intention healing has not been evaluated in the repair of wounds of the foot.

OBJECTIVE : To compare the functional and cosmetic results of secondary intention healing and full-thickness skin graft after wide excision of melanoma on the foot.

METHODS : Retrospective review of 25 patients who were treated using excision for melanoma on the foot. The defects of 13 patients were healed by secondary intention (secondary intention healing group; SIHG), and those of 12 patients were repaired by full-thickness skin graft (skin graft group; SGG).

RESULTS : The SGG showed more rapid healing than the SIHG, but the SIHG showed better functional and cosmetic outcomes at complete re-epithelialization than the SGG as evaluated by patients and independent physicians.

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