Arch Plast Surg.  2013 May;40(3):198-202. 10.5999/aps.2013.40.3.198.

Impact of Disturbed Wound Healing after Surgery on the Prognosis of Marjolin's Ulcer

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. baeyc2@hanmail.net

Abstract

BACKGROUND
Marjolin's ulcer is known to present a high proportion of recurrence and poor prognosis compared to other kinds of skin cancer. Based on our experience, Marjolin's ulcer patients who have received reconstructive surgery present a higher proportion of recurrence when there was disturbed wound healing after surgery. The impact of disturbed wound healing after surgery on the prognosis was examined in this study.
METHODS
A retrospective study was carried out on 26 patients who were diagnosed with Marjolin's ulcer and received surgery in this hospital from 1996 to 2011. Histologic grading, lymph node metastasis at diagnosis, and the wound healing process were evaluated and chi-squared analysis applied in order to determine the correlation with recurrence.
RESULTS
The proportion of recurrence increases in patients with a low histologic grade or lymph node metastasis at diagnosis. The proportion of recurrence is even higher when the problem occurs during the wound healing process after surgery.
CONCLUSIONS
Disturbed wound healing after surgery could be used as a sign to quickly identify the recurrence of carcinoma. Therefore, in the event a problem occurs in the wound healing process after surgery, one should keep in mind that this could be a sign of the possibility of recurrence and proceed with careful observation and active diagnosis through additional physical examinations, general X-ray tests, computed tomographys, magnetic resonance imagings, and so on, to obtain an early diagnosis of recurrence.

Keyword

Carcinoma, squamous cell; Skin ulcer; Wound healing; Prognosis

MeSH Terms

Carcinoma, Squamous Cell
Early Diagnosis
Humans
Lymph Nodes
Magnetic Resonance Spectroscopy
Neoplasm Metastasis
Physical Examination
Prognosis
Recurrence
Retrospective Studies
Skin Neoplasms
Skin Ulcer
Ulcer
Wound Healing
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