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


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.
Poos
H P A M
HP
Department of Surgical Oncology, University Medical Centre Groningen, University of Groningen, The Netherlands.
Kruijff
S
S
Bastiaannet
E
E
van Ginkel
R J
RJ
Hoekstra
H J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000473:pathology*; D014945:Wound Healing; D055815:Young Adult