Efficacy of intraoperative topical Sapylin (OK-432) for preventing lymph leakage following inguinal lymph node dissection in melanoma: a retrospective cohort study.

OBJECTIVE

To evaluate whether intraoperative topical Sapylin (OK-432) reduces postoperative lymphatic leakage after inguinal lymph node dissection (ILND) in melanoma patients.

METHODS

This retrospective study included 105 melanoma patients who underwent unilateral ILND (2022-2025). The study group (n = 51) received intraoperative topical Sapylin; the control group (n = 54) received saline. Both groups underwent Sartorius muscle flap coverage. Lymphatic leakage incidence, recovery indicators, and complications were compared. Logistic regression was used to identify risk factors.

RESULTS

Lymphatic leakage was significantly lower in the Sapylin group (9.8% vs. 25.9%, P = 0.03). Multivariable analysis confirmed age ≥ 60 years as an independent risk factor (OR = 4.93, P = 0.01) and Sapylin use as an independent protective factor (OR = 0.30, P = 0.04). The study group also showed reduced total drainage volume, shorter drain removal time, faster wound healing, and shorter hospital stay (all P < 0.05). No significant between-group differences were observed in fever or surgical site infection.

CONCLUSION

Intraoperative topical Sapylin is safe and effective for reducing postoperative lymphatic leakage and accelerating recovery after inguinal lymph node dissection for melanoma.

TRIAL REGISTRATION: This trial was registered in the Chinese Clinical Trial Registry (ChiCTR) on September 23, 2025 (Registration Number: ChiCTR2500109640; URL: https://www.chictr.org.cn/showproj.html?proj=287559 ).