足跟部黑色素瘤广泛切除和足底内侧皮瓣修复的手术疗效

Efficacy for reconstruction of heel defect with medial plantar flap after large resection of malignant melanoma

关键词:  恶性黑色素瘤  手术治疗  足底内侧皮瓣

Key words:  melanoma  operative treatment  the medial plantar flap

摘要:

[目的] 探讨足跟部黑色素瘤的广泛切除和足底内侧皮瓣修复的手术疗效。[方法]大连医科大学附属第一医院骨科于2003年—2006年共收治的13例足跟部皮肤恶性黑色素瘤患者,局部广泛切除后采用足底内侧皮瓣修复，对其临床资料和随诊结果进行分析。[结果]术后皮瓣均成活，均无复发和继发性溃疡发生。皮瓣感觉功能良好，按照AJCC外科分期，I期2例，II期4例，III期6例，IV期1例。随访5年生存率分别是100 %,75 %,50 %,0 %。[结论]手术是黑色素瘤的关键治疗方法。足跟部黑色素瘤的广泛切除后，首选足底内侧皮瓣修复软组织缺损，可获得良好的临床疗效。

Abstract:

[Objective] To study the efficacy of reconstruction of heel defect with medial plantar flap after large resection of malignant melanoma. [ Methods] Since 2003 to 2006, 13 patients with heel malignant melanoma were treated in our department by surgical treatment. The heel defects caused by resection of melanoma were reconstructed with the medial plantar flap. Their clinical materials and follow up results were retrospectively analyzed. [Results] All grafts survived without recurrence and ulcer. Sensory function recovery of the flap was satisfactory. According to AJCC Staging system, 2 were in stage I,4 were in stage II, 6 in stage III, and 1 in stage IV. The 5-year overall survival rate was 100%,75%,50%,0% respectively. [Conclusion] Surgical excision remains the key treatment of melanoma. The medial plantar flap which is the first therapia for heel defect after resection of malignant melanoma can achieve good clinical efficacy.