122P - Impact of surgical management in improving the quality of life in patients diagnosed with Marjolin's ulcer: A prospective observational study from a tertiary care center in India

Background

Marjolijn’s ulcer arising from an underlying chronic condition significantly impacts the patient's life's physical, socioeconomic and psychological aspects. On the contrary, owing to the rarity, the evidence on the improvement of QoL with available treatment modalities is limited.

Methods

A prospective observational study was conducted in the departments of plastic and general surgery at Post graduate institute of medical education and research, Chandigarh, India between 1^st July 2021 to 31^st December 2022. All the patients with histological diagnoses of Marjolins ulcer who underwent surgical management were included in the study. Details regarding the clinical presentation, radiological and histological features, intraoperative details, and post-operative outcomes like In-hospital stay, Time for wound healing, postoperative morbidity, and 90-day mortality were noted and analyzed. The effect of surgical management on QoL assessment was made using self-administered Wound QOL score and LLFI score which was measured both in the preoperative and the postoperative period.

Results

A total of 30 patients were included with mean age being 48.7 years and most common inciting injury being thermal burns (73.3%, n=22) which was managed conservatively (76.6%, n=23). Lower limb was the most common location (63.3%, n=19) and SCC was the most common histological variant (90%, n=27). WLE was performed in 24 patients with reconstructive surgery in 19 of them. Recurrence rate was found to be 10% with presence of bone involvement (p=0.033) and inciting injury being thermal burns (p=0.008) were found to be predictors of recurrence. Significant improvement in quality of life after surgery (p<0.001) using both the scoring system more so with excision than amputation.

Conclusions

Marjolin’s ulcer is an aggressive tumor with a recurrence rate of 10% within one year. Quality of life of these patients significantly improve following surgery and more so following excision than amputation. Thus, early diagnosis and definitive treatment with adequate follow up can decrease the morbidity and improve the quality of life in such patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.