Melanoma, sentinel node, and full-thickness skin graft: modification of Junod's procedure

Excision and reexcision of melanomas of the lower extremities and especially the toe area, the sole, or the top of the foot, frequently result in defects that, due to their location, can only be covered by complex local or free flap techniques. Split or full-thickness skin grafts are also a good option for wound coverage. For this purpose, one frequently waits for granulation tissue to form, which requires another operation at a later date. In melanomas with a thickness of ≥ 1mm, along with reexcision, a sentinel lymph node biopsy is performed for diagnostic reasons, with the sentinel lymph node typically located in the inguinal area. Using a patient with acral lentiginous melanoma as an example, we describe the use of the single-stage Junod’s procedure (inguinal crossectomy with simultaneous harvesting of a skin spindle for coverage of a leg ulcer) [1] in the above-mentioned scenario.