Secondary Intention Healing After Functional Surgery for In situ or Minimally Invasive Nail Melanoma

Nail melanoma (NM) is a rare subtype of cutaneous me-lanoma of the nail unit (1, 2). Previously, amputation was considered the treatment of choice regardless of disease stage (3). However, recent studies have shown that con-servative surgery has excellent oncological, functional, and cosmetic outcomes for NM in situ (NMIS) or minimally invasive (Breslow thickness <= 0.5 mm) NM (MINM) (3, 4). Functional surgery requires excision of the nail unit with at least 5-mm margins. Owing to the limited skin reservoir in the nail unit, surgical defects cannot be closed using primary closure. To date, various reconstructive methods, including local flap, free flap, full-thickness skin graft (FTSG), and secondary intention healing (SIH) have been reported. SIH is a good method for NM without the need for sophisticated reconstructive procedures and loss of donor tissues (5, 6). The main limitations of SIH are concerns about infection and long healing time. However, to our knowledge, there are no detailed data in the literature about the recovery time and outcomes of SIH. This in-formation is relevant to surgeons as well as patients with impeding surgery with NM. Therefore, this study aimed to evaluate the healing time, functional and cosmetic outco-mes, postoperative complications, and subjective patient satisfaction of SIH after conservative surgery for NM.