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

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.