Korean J Dermatol.  2013 Jan;51(1):65-68.

Negative-Pressure Therapy for Pre-and Post-grafting after Wide Extirpation Excision of Melanoma of the Toe

• Kim JH
• Roh MR
• Nam K
• Jee H
• Lee HB
• Chung KY

Abstract

Surgical management of acral lentiginous melanoma on the toe poses a difficult challenge because of the lack of surrounding tissue. A full-thickness skin graft after excision may provide a good cosmetic outcome, but graft failure can occur due to limited blood flow of the toe and the thin skin covering over the deep fascia in the pressure bearing area may cause gait disturbance. A negative-pressure device can be beneficial for fixing the graft and stimulating the growth of granulation tissue. A 55-year-old woman diagnosed with malignant melanoma on the right third toe underwent wide excision, after which secondary intention healing was initiated using negative-pressure therapy. When the wound had regenerated enough granulation tissue after 2 weeks, a full-thickness skin graft was performed, which was secured with negative-pressure therapy. The graft was successfully taken after a week thereafter. Accordingly, the use of negative-pressure therapy in the surgical management of acral lentiginous melanoma may be a good option because it facilitates full-thickness skin graft survival in an avascular surface area and aids in the thickening of the pressure bearing area, where acral lentiginous melanoma is likely to occur.

Keyword

Full-thickness skin graft; Melanoma; Negative pressure therapy; Toe

MeSH Terms

Cosmetics
Fascia
Female
Gait
Graft Survival
Granulation Tissue
Humans
Intention
Melanoma
Skin
Toes
Transplants
Ursidae
Cosmetics