Therapeutic groin dissection for melanoma: risk factors for short term morbidity

Eur J Surg Oncol. 2009 Aug;35(8):877-83. doi: 10.1016/j.ejso.2008.10.012. Epub 2008 Dec 2.

Abstract

Aims: Ilio-inguinal lymph node dissection for stage III melanoma is often complicated by wound healing disturbances. A retrospective study was performed to investigate the wound healing disturbances after therapeutic ilio-inguinal lymph node dissection.

Patients and methods: Between 1989 and 2007, 139 consecutive patients, 73 females (53%) and 66 males (47%), median age 55 (range 20-86) years underwent a therapeutic ilio-inguinal lymph node dissection. Data were recorded on early complications: haematoma, wound infection, wound necrosis and seroma. Univariate and multivariate logistic regression analyses were used to evaluate the influence of a wide range of variables on postoperative complications.

Results: Seventy-two patients had one or more early wound complications (49.7%). These complications comprised haematoma (n=3, 2.1%), wound infection (n=30, 20.7%), wound necrosis (n=25, 17.5%) and seroma (n=31, 21.8%). Wound infections were significantly more common in patients with a body mass index (BMI) of >25 (p=0.019). Wound necrosis developed significantly more often if the Bohler Braun splint was not used postoperatively (p=0.002). The occurrence of one or more early complications was significantly associated with the non-use of a Bohler Braun splint (p=0.026) and age of >55 years (p=0.015).

Conclusions: High BMI was significantly correlated with the occurrence of wound infections. Bed with of the hip and knee in flexion using a Bohler splint improved wound healing after therapeutic ilio-inguinal lymph node dissection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Lymph Node Excision*
  • Lymph Nodes / pathology*
  • Male
  • Melanoma / pathology*
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Factors
  • Skin Neoplasms / pathology*
  • Wound Healing
  • Young Adult