A Case of Giant Basal Cell Carcinoma Healed with Secondary Closure through Purse String Suture after Mohs Micrographic Surgery / 대한피부과학회지

No abstract available.

Delayed Reconstruction for the Non-Amputative Treatment of Subungual Melanoma

BACKGROUND: In cases of early stage subungual melanoma (SUM), conservative treatment with non-amputative wide excision of the nail unit and subsequent skin graft is preferred over amputation to preserve the involved digit. OBJECTIVE: We report a series of patients with SUM treated with conservative surgery and suggest an effective supplementary treatment process. METHODS: We retrospectively reviewed 10 patients (2 males, 8 females) who were diagnosed with in situ or minimally invasive SUM on the first biopsy and underwent non-amputative wide excision of the nail unit. All patients underwent secondary intention healing during the histopathological re-evaluation of the entire excised lesion, and additional treatment was administered according to the final report. RESULTS: In two of 10 patients, amputation was performed because of the detection of deep invasion (Breslow thickness: 4.0, 2.3 mm) from the final pathologic results, which differed from the initial biopsy. In six patients who received delayed skin graft, the mean total time required for complete healing after secondary intention healing and the skin graft was 66.83+/-15.09 days. As a result of this delayed skin graft, the final scarring was similar to the original shape of the nail unit, scored between 5 and 10 on a visual analogue scale. Most patients were satisfied with this conservative surgery except one patient, who had volar portion involvement and received an interpolated flap instead of a skin graft. CONCLUSION: Our treatment process can reduce the risk of incomplete resection and improve cosmetic outcomes in patients with SUM.

Secondary Intention Healing of Large Mohs Defects of the Forehead and Temple / 대한피부과학회지

Defects resulting from Mohs micrographic surgery may immediately be reconstructed with primary repair, flaps or grafts, or the wound may be allowed to heal by secondary intention. We experienced 3 cases of secondary intention healing using occlusive dressing and purse-string suture, and wounds were healed with excellent cosmetic and functional results. Therefore, we conclude that secondary intention healing of forehead and temple wounds is a safe and effective method of wound management after Mohs micrographic surgery.

Repair of Defect Caused by Surgical Removal of Skin Cancers by Secondary Intention / 대한피부과학회지

BACKGROUND: There are a few methods, including primary intention, deleyed primary closure and secondary intention, to irpair several types of defects. But commonly-used primary intentional repair of a defect after surgical removal of a skin cancer by graft, flap or simple closure has several limitations such as the need of a skillful technique and various complications. OBJECTIVE: We undertook a secondary intention using occlusive dressing with a polyurethane film after skin cancer surgery instead of a primary repair and evaluated its efficacy, particularly in points of simplicity and safety, and cosmetic results. METHODS: We randomly chose 14 cases of skin cancers in 13 patients who had undergone simple surgical excision or Mohs micrographic surgery and then undertook secondary intention with polyurethane film after informed consent. Postsurgical wound care included cleansing with normal saline or boric acid, then covering the defect with antibiotic ointment, gauze and film a at regular intervals.