局部皮瓣修复术治疗足底部恶性黑色素瘤15例

目的 探讨足底部恶性黑色素瘤扩大切除后行局部皮瓣修复的手术疗效.方法 本院2009-2012年收治的足底恶性黑色素瘤患者15例,扩大切除后,行逆行性腓肠神经皮瓣修复6例,足底内侧皮瓣修复9例,术后经内科综合治疗,对两组患者临床资料和随诊结果进行分析.结果 所有患者均获随访,随访时间1～4年,平均2.3年,15例随诊患者无进展生存,病灶均未复发和远处转移.术后皮瓣均成活,皮瓣颜色、质地及足部外形基本正常,两组患者可不负重无痛行走,负重行走伴有不同程度疼痛.结论 手术是治疗足底恶性黑色素瘤的关键方法,尽早切除肿瘤后选择合适皮瓣修复,均获得良好临床疗效.

Surgical treatment for 15 cases of malignant melanoma in heels

Objective To study the clinical effect of reconstruction of heel defect with medial plantar flap after large resection of malignant melanoma. Methods Since 2009 to 2012, 15 patients with heel malignant melanoma were treated by surgical treatment in our hospital. They were treated by reverse sural neurocutaneons flap 6 cases and medial plantar flap 9 cases after large resection of malignant melanoma of heel, and medical comprehensive treatment. Two groups of patients with clinical data and follow-up results were analyzed. Results 15 patients had complete date, with the mean follow-up period being 2.3 years, （ range, 1 - 4 years） , all cases survived with neither local recurrence nor distant metastasis, their local flap grafting also survived. The flaps had normal texture, color and appearance of heel. All patients were pain-free walking, the pain existed in weightbearing walking. Conclusions The method of operation is the key to the treatment of plantar malignant melanoma, choosing appropriate skin flap after resection of tumor to repair as soon as possible, have got good clinical curative effect.