Dresel Alexandra, Kuhn Joseph A, McCarty Todd M
Baylor University Medical Center, Department of Surgery, Dallas, TX 75246, USA.
Am J Surg. 2002 Aug;184(2):176-8. doi: 10.1016/s0002-9610(02)00917-0.
Wound defects after wide local excision (WLE) for cutaneous melanoma can occasionally require the use of skin grafts for closure. Harvesting the skin graft can result in an additional wound.
The increasing use of sentinel lymph node (SLN) biopsy in cutaneous melanoma at our institution has facilitated the development of an alternative technique for obtaining donor skin. The proposed method utilizes the skin overlying the SLN as the skin graft donor site. Sixteen patients underwent WLE of intermediate to thick melanomas with SLN biopsy and full thickness skin graft harvested from the SLN biopsy site.
After a median follow-up of 12 months, there were no graft failures. There were 2 partial graft losses. There were no wound complications. There were no melanoma recurrences.
In cases where primary closure is not technically feasible or cosmetically favorable, the use of the SLN incision site as a skin graft donor provides the surgeon with an effective repair and spares the patient an additional skin graft donor site defect.
皮肤黑色素瘤广泛局部切除（WLE）后的伤口缺损有时需要使用皮肤移植来闭合。采集皮肤移植会导致额外的伤口。
在我们机构，前哨淋巴结（SLN）活检在皮肤黑色素瘤中的使用日益增加，这促进了一种获取供皮的替代技术的发展。所提出的方法利用覆盖SLN的皮肤作为皮肤移植供区。16例中厚黑色素瘤患者接受了WLE及SLN活检，并从SLN活检部位采集了全厚皮肤移植。
中位随访12个月后，无移植失败。有2例部分移植丢失。无伤口并发症。无黑色素瘤复发。
在一期闭合在技术上不可行或美容效果不佳的情况下，使用SLN切口部位作为皮肤移植供区可为外科医生提供有效的修复方法，并使患者免于额外的皮肤移植供区缺损。
