Extramammary Paget’s disease (EMPD) and Skin Grafts
What is a Skin Graft?
A skin graft involves moving tissue from one location to another. A split-thickness skin graft (STSG) is sometimes used when large areas of extramammary Paget’s disease (EMPD) skin cancer are removed. A STSG has a low chance of rejection.
A STSG differs from a full-thickness skin graft (FTSG), which includes removing the epidermis and the entire thickness of the dermis. During a STSG procedure, a thin layer of skin encompassing the epidermis and a small part of the dermis is removed. The process is akin to to peeling a vegetable.
As the donor site for the split-thickness skin graft heals, the foam bandages release. This photo was taken nine days after surgery.
During surgery, doctors use a dermatome to carefully remove thin slices of skin from a donor area. Skin grafts typically require the patient to be immobile for days after surgery to insure that grafts healing properly. Full recovery time from skin grafts can be long for some people.
Both STSG's and FTSG's are often used in EMPD surgeries with split-thickness skin grafts being more common.
STSG’s vary in depth with thin grafts ranging from .005 inch to .012 inch, medium grafts ranging from .012 inch to .018 inch and the thick grafts ranging from .018 inch to .030 inch. FTSG's are thicker than .030 inch.
Often the most challenging part of a STSG is the pain associated with the donor site. As the STSG heals on the donor site, the bandages release starting with the edges. In split-thickness skin grafts the entire donor site bandage often removes itself within two weeks.
In male EMPD patients, with large areas of EMPD on the scrotum, split-thickness skin grafts can be used to entirely rebuild a scrotum.
In addition to a STSG, skin flaps can also be used in extramammary Paget’s disease surgery. This can occur when excess tissue is available near the EMPD site. Surgeons can pull non-cancerous tissue to create a flap over an area where EMPD was removed.
Treatments for extramammary Paget’s disease (EMPD) often differ but frequently include one or more of the following: Mohs surgery, wide local excision (WLE) surgery, topical creams, carbon dioxide (CO2) laser, photodynamic therapy (PDT), cavitational ultrasonic surgical aspiration (CUSA), radiation therapy, skin grafts, and chemotherapy.
The content presented on this website, encompassing both textual material and visual media, serves educational and informational purposes aimed at aiding individuals affected by extramammary Paget’s disease (EMPD) and their families in comprehending the complexities associated with EMPD. It is imperative to note that the website is not designed to serve as a replacement for professional medical advice, diagnosis, or treatment. Furthermore, the website does not advocate for or endorse any specific treatments, tests, physicians, procedures, or products. Should you suspect that you are experiencing symptoms of EMPD, we strongly advise you to seek guidance from your healthcare provider.