Current Trends in Management of Marjolin's Ulcer: A Systematic Review.

Autor:	Kanth AM; Division of Plastic Surgery, Albany Medical Center., Heiman AJ; Division of Plastic Surgery, Albany Medical Center., Nair L; Albany Medical College, Albany, New York., Giammarino A; Albany Medical College, Albany, New York., Carpenter C; Division of Plastic Surgery, Albany Medical Center., Ricci JA; Division of Plastic and Reconstructive Surgery, Montefiore Medical Center, Bronx, New York., Patel A; Division of Plastic Surgery, Albany Medical Center.
Jazyk:	angličtina
Zdroj:	Journal of burn care & research : official publication of the American Burn Association [J Burn Care Res] 2021 Mar 04; Vol. 42 (2), pp. 144-151.
DOI:	10.1093/jbcr/iraa128
Abstrakt:	Marjolin's ulcer (MU) is a rare, aggressive entity with frequent delay in diagnosis for a variety of regions. Although well described and classically taught in medical school, aspects of its treatment remain ill-defined and controversial. A systematic review was performed according to PRISMA guidelines to identify studies discussing patients who underwent surgical treatment of MU. A total of 31 papers, reporting on 1016 patients, were included. Burns were the most common etiology of malignant degeneration (68%), followed by trauma. The lower extremity was most affected (51%) and Squamous Cell Carcinoma (SCC) was found in 94% of cases, with the majority being well differentiated. Basal cell carcinoma and melenoma composed a minority of cases. Melanoma occurred more frequently in previously skin grafted wounds and had a higher rate of metastases than SCC. Most patients did not have associated regional or distant metastases present at diagnosis. Wide local excision (71%) was performed in most cases, unless amputation was indicated for severe disease or bone involvement. Lymphadenectomy and sentinel lymph node biopsy were variably reported, with conflicting evidence on the efficacy. Lymphadenectomy was most commonly indicated for known lymph node involvement. In cases of metastatic disease chemotherapy and radiation were used in conjunction with surgical treatment. Despite numerous articles on this topic, controversy remains in the management of MU. Early diagnosis of suspicious chronic wounds and prompt surgical intervention remains imperative to its treatment. (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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