Evidence from Clinical Studies Related to Dermatologic Surgeries for Skin Cancer

Abstract

Despite the significant progress made in the past several years in pharmacotherapies for skin cancer, such as BRAF/MEK inhibitors, immune checkpoint inhibitors, and Hedgehog pathway inhibitors, surgical removal of primary skin cancer is still the first choice of treatment unless distant metastases are evident. In cases of lymph node metastases with clinically palpable lymphadenopathy, lymph node dissection (LND) is typically performed for most skin cancers. In the surgical treatment of primary skin tumors, the surgical margin is critical not only for reducing the possibility of tumor recurrence but also for minimizing the cosmetic and functional complications associated with wide local excision. In contrast, dermatologic surgery can cause various complications. Although skin graft is frequently used for reconstruction of the surgical defect, extensive graft necrosis may develop if optimal stabilization of the graft is not obtained. LND also sometimes causes complications such as intraoperative or postoperative bleeding and postoperative lymphoceles. Moreover, as in other types of surgery, surgical site infection, intraoperative anxiety, and intraoperative and postoperative pain may also develop. These complications are frequently associated with significant morbidity and discomfort. In this review, we summarize the evidence from previous clinical studies regarding the optimal surgical margin for skin cancer and the methods for diminishing the complications associated with dermatologic surgery.

Cliniciopathological Spectrum of Skin and Soft Tissue Swellings at a Tertiary Care Hospital of Lahore, Pakistan

“…A subset of individuals (10%) in our retrospective study also manifested SSIs, and 6.67% had graft or flap rejection. SSIs can cause sutural rupture and graft necrosis [ 13 ]. Transitory surgical edema and tissue collections are usually expected in plastic and reconstructive surgeries.…”

“…The majority of SSTS are removed under local anesthesia, hence anxiety and post-operative pain are anticipated postoperative sequelae, especially in patients undergoing face and scalp surgery [ 13 ]. However, our patients received an adequate cover of analgesics before and after the procedures and this was not an observed complication.…”

“…However, our patients received an adequate cover of analgesics before and after the procedures and this was not an observed complication. Hand-holding by nurses, listening to music, stress balls, and anxiolytic drugs are usually implied methods to decrease peri-operative restlessness and anxiety [ 13 ].…”

Gene Regulations upon Hydrogel-Mediated Drug Delivery Systems in Skin Cancers—An Overview

“…Surgical and non-surgical treatments such as topical therapies are mostly carried out for skin cancer lesions [ 51 ]. Depending on the cancer progression stage, skin cancers can be treated by surgery [ 52 ], immunotherapy [ 53 ], cryosurgery [ 54 ], laser therapy [ 55 ], curettage, desiccation [ 56 ], dermabrasion [ 57 ], targeted therapy, photodynamic therapy [ 58 ], chemotherapy and radiotherapy [ 59 ]. Commonly used medications against melanoma include 5-fluorouracil (5-FU, Efudex), Imiquimod, Resiquimod, Ingenol mebutate, Diclofenac, cisplatin, etc.…”