Skin oncoplasties: O-to-Z technique a technique of choice in situation of limited resources? Case of Burkina Faso

Background: In developing countries, the long delays in consultation lead to a delay in diagnosis and management of the skin tumors. The lesions are often large and bring the problem of skin coverage after their resections. Several reconstruction techniques allow skin coverage. The objective of this study is to describe the place of O-to-Z technique in the surgical treatment of skin cancers in Ouagadougou. We hypothesized that O-to-Z technique reduces healing times and the number of dressings compared with directed wound healing. Patients and methods: It was a two-center, retrospective, descriptive study on O-to-Z technique in skin cancers. It included patients who underwent surgery between January 1st, 2013 and March 30th, 2021 in Ouagadougou. Scar quality and healing time in Z-plasty were compared with those of secondary healing. We used the Student’s t test. Results: In 8 years and 3 months, 171 skin cancers were identified. The mean time to consultation was 13.6 months. The average size of the tumors was 9 cm. An O-to-Z technique was performed in 42 cases, being 58.3% of the patients operated on. The average healing time was 15 days. It was four and a half times shorter in O-to-Z technique than in secondary healing. Ischemic necrosis of the Z-corner was noted in 7 cases. The recurrence rate in O-to-Z technique and secondary healing was 7.1% and 9.1% respectively. Hypertrophic or keloidal scars were noticed in 7 cases and hypochromia in 2 cases. Conclusion: O-to-Z technique is a technique of choice for skin coverage after large resections in surgical oncology. It reduces the healing time and the cost of postoperative care without increasing the risk of tumor recurrence.