GPfeedback

"We have been very impressed with the Halo graft and have performed around 30 of these procedures in our practice. The beauty of the graft technique is that it is simple to do, the patient is immediately mobile and there's no need for hospitalization. Also post operative discomfort is minimal.

We use the technique as described by Dr. Sharad Paul, though we tend to use a 'shave biopsy' blade rather than a large scalpel blade. Pre operatively we have the patient wash the site for one week with an antiseptic wash, and if oedema is present request they wear surgical stockings daily. At the time of the procedure, we outline the appropriate markings before preparing and infiltrating with local anaesthetic.

Previously we performed a number of flap type procedures for NMSC on the lower limb including the Behan keystone flap. The difficulty here is vascular compromise and infection. Now unless we are treating melanoma, we virtually use the Halo graft exclusively for lower limbs if primary closure is not possible.

We have also used the technique for large scalp lesions normally requiring flap closure. (Where haemostasis can be a problem). Again we have been happy with the results."

Drs Graham Sivyer, John Salkeld and Denis O'Brien. Mermaid Beach Skin Diagnostic Centre Gold Coast

Shown are three photographs of excision of squamous cell carcinoma using the Halo graft (split skin) on a lower limb at operation and at 3 months.