The following is a summary of “Comparative analysis of one-step and two-step full thickness skin grafting and secondary intention healing for skin defects after surgical management of plantar malignant melanoma,” published in the September 2024 issue of Dermatology by Kato et al.
Researchers conducted a retrospective study analyzing the use of skin grafts to reconstruct skin defects following plantar malignant melanoma surgery.
They analyzed data from 49 patients, 23 males, and 26 females, with a mean age of 70.4 years, who underwent excisional surgery for plantar malignant melanoma (March 2018 and December 2022). Wound healing time was analyzed using a multivariate Cox proportional hazards model, and related factors were identified. Cases with lesions in non-weight-bearing areas and segmental layer grafts were excluded to avoid bias. Patients were categorized into three groups: one-step skin grafting, two-step skin grafting, and secondary intention healing without skin grafting.
The results showed that a defect size larger than 1,800 mm2, 2-step skin grafting, and split-thickness skin grafting were associated with longer wound-healing time. Based on data from 37 patients (excluding 9 cases in non-weight-bearing areas and 3 cases with split-thickness skin grafts), Kaplan–Meier curves were constructed for the 3 cohorts. The median times from the initial surgery to wound healing were 14.6 weeks, 12.0 weeks, and 21.9 weeks for the 1-step, 2-step, and secondary intention healing cohorts. A statistically notable change in the treatment time was observed between the skin grafting and secondary intention healing cohorts (P<0.001) and between the 1-step and 2-step skin grafting cohorts (P=0.046).
They concluded that 2-step skin grafting after surgical treatment for plantar malignant melanoma might shorten the overall treatment duration by allowing granulation to occur.
Source: onlinelibrary.wiley.com/doi/abs/10.1111/1346-8138.17398
