Muhammad Saleem, Moazzam .N.Tarar, Husnain Khan, Ata Ul Haq
Marjolin’s ulcer is cutaneous malignant tumor arising from chronically inflamed or traumatized skin. It commonly occurs in burn scars but can also originate from venous ulcers, pressure sores and chronic osteomyelitis sinuses. The major risk factors for development of neoplasms are healing by secondary intention, non healing wounds and fragile scars that ulcerate easily. Our series reviews 17 cases of Marjolin’s ulcer, who presented at Plastic Surgery Department Jinnah Hospital Lahore from June 2005 to June 2011. In 11 cases Marjolin’s ulcer occurred after burns and six after traumatic wounds. In 16 cases wound had healed by secondary intention. After establishing diagnosis by incisional biopsy, 16 cases underwent wide excision and skin graft or flap for coverage. Below knee amputation was performed in one patient. Three patients had recurrence and above-knee amputation was performed in one patient, he is disease free one year after the amputation. Two patients died who had recurrence over scalp. Mean follow up period was 3 years. Three patients were lost to follow-up and 12 cases were tumor-free during the follow-up period. We concluded that cure rate for early cases is high as compared with advanced cases. Marjolin’s ulcer can be prevented by promoting wound healing by primary intention and early coverage of wound
defects with graft or flap.