22 | Surgical radicality and reconstructive techniques in melanoma and non-melanoma skin cancer

A. Lenta, A. Amore, L. Benedetto, C. Caracò | Chirurgia del Melanoma e dei tumori cutanei, Istituto Nazionale Tumori "Fondazione Pascale", Napoli, Italy.

Background: This prospective case series evaluated the clinical outcomes of skin micro-fragment therapy in managing the excision of local advanced skin cancer. Recently, skin micro-fragment therapy has emerged as a promising alternative of classical skin graft reconstruction.

Methods: This technique involves the mechanical fragmentation of a small quantity of skin to produce autologous skin micrografts. When applied after the excision of the primary, around and inside the surgical bed, these grafts promote wound healing. Micro-fragmented skin tissue is a new mechanism able to conserve biological properties and capable of stimulating the regenerative process in chronic wounds that usually remain in the inflammatory phase. It acts as a slow released natural scaffold that preserves the extracellular matrix components which provides support to the gradual growth of the fibroblast metabolic activity, and continuously delivers growth factors and pro- and anti-inflammatory cytokines, which supports the regenerative response. No previous description of this technique was reported in surgical oncology field.

Results: A total of 25 patients with skin cancer were included in this study. 15 cases with primary SCC mostly located in the scalp or lower extremities. The primary outcome was the wound healing process, the post-operative management and the patient’s tolerability. The mean healing time was 54 days. The procedure was well tolerated with no complications with total absence of inflammation and infection of the treated site. No adverse effects related to the infiltration procedure at wound site were recorded with a promising wound healing rate during the follow-up period. All patients were monitored weekly until wound healing was accomplished. Wound healing was characterized as complete epithelialization without any discharge.

Conclusions: These results suggest that HT-MG could be a safe and effective treatment option for the treatment of skin cancer, promoting noteworthy wound healing and reducing healing times. Further studies are required to confirm these findings and assess long-term outcomes.