{"title":"甲器黑色素瘤功能性手术后的二次意向愈合：功能、美容和患者满意度结果。","authors":"Jonathan Stevens, Martín Céspede-Núñez","doi":"10.1159/000545468","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Functional surgery is the preferred approach for nail melanoma in situ (NMIS) and minimally invasive nail melanoma (MINM, Breslow ≤0.5 mm). Secondary intention healing (SIH) offers an alternative to traditional skin grafting, with favorable cosmetic, functional, and satisfaction outcomes and minimal complications.</p><p><strong>Methods: </strong>Six patients (mean age 54.8 years; 4 SMIS, 2 MISSM) underwent functional surgery with SIH. Healing times (granulation [T1] and re-epithelialization [T2]), complications, and outcomes were assessed at 12 weeks using QUICK-DASH, VBSAS, VAS, satisfaction scores, and DLQI.</p><p><strong>Results: </strong>Mean T1 and T2 were 2.83 and 8.45 weeks, respectively. One patient experienced intense postoperative pain; another had a late nail spike. No hyperpigmentation or recurrences were observed. Outcomes: QUICK-DASH 18.92%; VBSAS 2.8 (12 weeks) and 0.25 (24 weeks); VAS 2; DLQI 2; and satisfaction 9.8/10 (10/10 after amputation discussion).</p><p><strong>Conclusions: </strong>SIH provides an effective alternative to grafting, allowing acceptable healing times, flexibility for margin extension or amputation, and excellent cosmetic, functional, and satisfaction outcomes with minimal complications.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"1-8"},"PeriodicalIF":1.4000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058123/pdf/","citationCount":"0","resultStr":"{\"title\":\"Secondary Intention Healing after Functional Surgery for Melanoma of the Nail Apparatus: Functional, Cosmetic, and Patient Satisfaction Results.\",\"authors\":\"Jonathan Stevens, Martín Céspede-Núñez\",\"doi\":\"10.1159/000545468\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Functional surgery is the preferred approach for nail melanoma in situ (NMIS) and minimally invasive nail melanoma (MINM, Breslow ≤0.5 mm). Secondary intention healing (SIH) offers an alternative to traditional skin grafting, with favorable cosmetic, functional, and satisfaction outcomes and minimal complications.</p><p><strong>Methods: </strong>Six patients (mean age 54.8 years; 4 SMIS, 2 MISSM) underwent functional surgery with SIH. Healing times (granulation [T1] and re-epithelialization [T2]), complications, and outcomes were assessed at 12 weeks using QUICK-DASH, VBSAS, VAS, satisfaction scores, and DLQI.</p><p><strong>Results: </strong>Mean T1 and T2 were 2.83 and 8.45 weeks, respectively. One patient experienced intense postoperative pain; another had a late nail spike. No hyperpigmentation or recurrences were observed. Outcomes: QUICK-DASH 18.92%; VBSAS 2.8 (12 weeks) and 0.25 (24 weeks); VAS 2; DLQI 2; and satisfaction 9.8/10 (10/10 after amputation discussion).</p><p><strong>Conclusions: </strong>SIH provides an effective alternative to grafting, allowing acceptable healing times, flexibility for margin extension or amputation, and excellent cosmetic, functional, and satisfaction outcomes with minimal complications.</p>\",\"PeriodicalId\":21844,\"journal\":{\"name\":\"Skin Appendage Disorders\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058123/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Skin Appendage Disorders\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000545468\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Skin Appendage Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000545468","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}
Secondary Intention Healing after Functional Surgery for Melanoma of the Nail Apparatus: Functional, Cosmetic, and Patient Satisfaction Results.
Introduction: Functional surgery is the preferred approach for nail melanoma in situ (NMIS) and minimally invasive nail melanoma (MINM, Breslow ≤0.5 mm). Secondary intention healing (SIH) offers an alternative to traditional skin grafting, with favorable cosmetic, functional, and satisfaction outcomes and minimal complications.
Methods: Six patients (mean age 54.8 years; 4 SMIS, 2 MISSM) underwent functional surgery with SIH. Healing times (granulation [T1] and re-epithelialization [T2]), complications, and outcomes were assessed at 12 weeks using QUICK-DASH, VBSAS, VAS, satisfaction scores, and DLQI.
Results: Mean T1 and T2 were 2.83 and 8.45 weeks, respectively. One patient experienced intense postoperative pain; another had a late nail spike. No hyperpigmentation or recurrences were observed. Outcomes: QUICK-DASH 18.92%; VBSAS 2.8 (12 weeks) and 0.25 (24 weeks); VAS 2; DLQI 2; and satisfaction 9.8/10 (10/10 after amputation discussion).
Conclusions: SIH provides an effective alternative to grafting, allowing acceptable healing times, flexibility for margin extension or amputation, and excellent cosmetic, functional, and satisfaction outcomes with minimal complications.
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