Excision of cutaneous malignancies often results in soft-tissue defects requiring skin grafting. Skin overlying the sentinel lymph node (SLN) basin may be procured as a full-thickness skin graft (FTSG), eliminating a problematic third wound (donor site). We demonstrate this technique and review our results.

Retrospective review of patients with cutaneous malignancy undergoing SLN biopsy and skin grafting from 2001-2006.

Fifty-seven patients had FTSG and thirty-nine patients had partial-thickness skin grafts (PTSG) placed at the time of wide excision and SLN biopsy. Most patients had melanoma; median thickness for FTSG patients (N=53) was 2mm versus 2.8mm for the PTSG group (N=29). Four FTSG and 8 PTSG patients had Merkel cell cancers. Two PTSG patients had "other" non-melanoma skin cancers. Positive nodes were found in nine (16%) and eleven (28%) patients in the FTSG and PTSG groups, respectively. Peri-graft recurrence rates were not significantly different 3(6%) and 4(11%). Graft "take" rates were similar between groups. FTSG cosmetic results were generally excellent and subsequent lymphadenectomy was not compromised.

This FTSG technique eliminates a third wound and does not appear to increase peri-graft recurrences. This technique should be in the armamentarium of surgeons who treat cutaneous malignancy.