Modified micrographic surgery for malignant melanomas of the face

Background and objective. Malignant melanomas on sun-exposed skin are often poorly circumscribed and thus recur frequently. The aim of our clinical tr ial was to compare conventional to a modified micrographic surgery of prima ry melanoma. Patients/Methods. 28 patients with in-situ (n=7) and invasive (n=21) melano ma were treated with conventional surgical excision with wide margins; eigh t of these patients developed a local recurrence. In comparison, 20 patient s with primary in-situ (n=7) and invasive (n=13) melanoma as well as four p atients with recurrence after conventional surgery underwent modified micro graphic surgery with delayed closure of the wound. Results. Paraffin specimens of the margins revealed in half of the patients remnants of melanoma although excision was extended to non-lesional skin. Within a mean followup period of 21.3 months, none of our patients treated by modified surgery developed a recurrence. Conclusions. Local recurrencies of melanoma on sun exposed skin may be avoi ded by means of a modified micrographic surgery using permanent histologic sections.