title: [Evaluation of a two-stage surgical strategy for the treatment of skin carcinomas. Retrospective study of 367 cases].
abstract: The treatment of skin carcinomas in France is mainly based on surgical resection. However, when the cutaneous surgical defect cannot be sutured, repair by skin graft or skin flap can be either immediate or delayed. The aim of the present study is to evaluate the value of delayed repair. A six-month retrospective study was designed between November 1997 and April 1998, on a total of 367 resections of skin carcinomas and/or premalignant lesions. Two parameters were recorded: management of the skin defect, and the histological results. Out of the 367 resections, there were 275 resections with suture, 42 resections with skin graft, 11 resections with skin flap, and 39 resections without wound closure. In 41 cases further re-excisions were performed because the tumors were incompletely excised. Incompletely excised tumors were found in 6% of sutures, 9% of skin flaps, 24% of skin grafts, and 36% of delayed repairs. The high rate of incomplete surgical resections supports two-step surgery without wound closure when the defect cannot be sutured. This attitude is reinforced by the difficulty of the re-excision when a skin graft or a skin flap has been previously performed.
authors.affiliation: Service de Chirurgie Plastique, Hôpital Saint-Louis, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Revol
authors.forename: A
authors.initials: A
authors.lastname: Bensoussan
authors.forename: O
authors.initials: O
authors.lastname: Verola
authors.forename: J M
authors.initials: JM
authors.lastname: Servant
mesh_terms: D002280:Basal Cell Carcinoma / Q000601:surgery*; D006801:Humans; D008866:Microsurgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome
vernacular_title: Evaluation de l'intérêt d'une stratégie chirurgicale en deux temps pour le traitement des carcinomes cutanés. Etude rétrospective de 367 cas.