Retrospective Analysis Of Clinical Efficacy Of Open Wound After Surgery Combined With 5-Aminolevulinic Acid Photodynamic Therapy For The Treatment Of Non-Melanotic Skin Cancers

Objective: To evaluate the clinical efficacy of open wound after surgery combined with5-aminolevulinic acid photodynamic therapy for the treatment of non-melanotic skin cancers by retrospective analysis.Methods: A total of 50 patients were included by counting patients with NMSC who visited the Department of Dermatology of Fuyang People’s Hospital for inpatient treatment from January 2020 to December 2021,according to the inclusion and exclusion criteria.They were divided into a control group treated by surgical excision alone and a treatment group treated with open wound after surgery combined with ALA-PDT immediately and once a week for three times.All patients were followed up at 1 month,3 months,6 months and 1 year after the end of treatment,and dermoscopy was performed to check for signs of tumor recurrence.The mean operating time and healing time,adverse effects of treatment,patient satisfaction,aesthetics and recurrence rate were evaluated in both groups.The results were analyzed retrospectively.Results: Among the 50 patients,22 were male and 28 were female,with a male to female ratio of 1:1.27;the age of onset ranged from 31 to 96(73.66±13.46)years,and the duration of the disease ranged from 1 month to more than 20 years.The median operative time was 85(52.5,117.5)minutes in the control group and 40(32.5,75.0)minutes in the treatment group,95% CI-30(-50 to-10).The difference was statistically significant between the two groups(Z=-2.879,P=0.004).The mean healing time in the treatment group was longer in the treatment group than in the control group(P<0.001),which was statistically significant.The incidence of pain was 100% in the treatment group and 72% in the control group,with a statistically significant difference(P<0.001).There was no serious adverse reaction in the treatment group,and the adverse reaction rate in the control group(36%)was statistically significant(P=0.014).The overall satisfaction rate of patients in the treatment group(96%)was significantly better than that of the control group(68%),with a statistically significant difference(P=0.027).The difference in aesthetics of patients in the treatment group(96%)was statistically significant(P=0.005)compared with the aesthetics of the control group(64%).At1-year postoperative follow-up,the recurrence rate was 16% in the control group and no recurrence was seen in the treatment group,with no statistically significant difference(P=0.118).Conclusion: Open wound combined with ALA-PDT after surgical resection can be used to treat NMSC,especially for NMSC in special sites,with large lesions not easily excised intact,not easily repaired after excision,or multiple NMSC,which can significantly reduce the operation time,improve patient tolerance,and increase the aesthetics and patient satisfaction rate.