The halo split skin graft in the management of non-melanoma skin cancer of the leg: a retrospective study

BACKGROUND The purpose of this study was to compare the results of the halo split skin graft (HSSG) by two primary care skin cancer practitioners at one clinic at the Gold Coast, Queensland, Australia, to the results of the only previous study while adding to the body of evidence regarding use of the HSSG following excision of non-melanoma skin cancer on the leg. METHOD A retrospective review of the notes (Jan 2010-Aug 2012) was performed of all cases of nonmelanoma skin cancer (NMSC) excisions in which split skin graft (SSG) closure with the HSSG was utilized on the leg. RESULTS There were a total of 68 HSSGs included over the 31 months of the study. Average lesion size was 19.4 mm (range 9-75 mm) and the average age of patients was 78 years (range 49-95 years) with 49% of patients being male. The average healing time was 4 weeks with 35/68 (51%) healing within 14 to 21 days. The overall infection rate was 8/68 (11.8%), which decreased to 4/53 (7.5%) when the ankle grafts were excluded. The graft failure rate was 7/68 (10%) with 3/68 (4.4%) having both infection and graft failure. LIMITATIONS This was a retrospective study. CONCLUSION The HSSG confines the surgical wounds to a single site, does not require specialized equipment and it is an economical and effective option for managing NMSC on the leg in situations where skin graft is indicated.