Choi Jae Yeon, Bae Yong Chan, Nam Su Bong, Bae Seong Hwan
Department of Plastic and Reconstructive Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Arch Plast Surg. 2013 May;40(3):198-202. doi: 10.5999/aps.2013.40.3.198. Epub 2013 May 16.
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.
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.
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.
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.
与其他类型的皮肤癌相比，Marjolin溃疡的复发率较高且预后较差。根据我们的经验，接受重建手术的Marjolin溃疡患者，若术后伤口愈合不良，则复发率更高。本研究探讨了术后伤口愈合不良对预后的影响。
对1996年至2011年在本院诊断为Marjolin溃疡并接受手术的26例患者进行回顾性研究。评估组织学分级、诊断时的淋巴结转移情况及伤口愈合过程，并应用卡方分析以确定与复发的相关性。
组织学分级低或诊断时有淋巴结转移的患者复发率增加。术后伤口愈合过程中出现问题时，复发率更高。
术后伤口愈合不良可作为快速识别癌症复发的迹象。因此，若术后伤口愈合过程中出现问题，应牢记这可能是复发的迹象，并通过额外的体格检查、普通X线检查、计算机断层扫描、磁共振成像等进行仔细观察和积极诊断，以早期诊断复发。
