足底恶性黑色素瘤切除与修复的研究

目的 探讨足底恶性黑色素瘤的手术切除与修复重建.方法 我科1999年7月至2008年2月收治足底恶性黑色素瘤16例,其中男10例,女6例;足跟部9例,跖弓部2例,前足掌部4例,趾趾腹区1例.行手术切除,带血管神经蒂足底内侧岛状皮辨(跖弓部用全层皮片)修复术后软组织缺损区.结果 成活良好16例.其中1例顺行皮瓣术后第3天边缘约1cm×0.5 cm出现静脉危象.经用尖刀片划孔促进回流5 d恢复;1例逆行皮瓣术后第4天边缘约2.5 cm×0.5咖坏死,经换药后痂下愈合.随访6个月～5年.16例均健在,未见复发,皮瓣感觉、色泽、痛觉、耐磨性、负重功能良好.结论 足底恶性黑色素瘤应行广泛切除术,对于足跟区和前足恶性黑色素瘤,术后用足底内侧岛状皮瓣修复,临床效果满意.

Resection and reparation of planta pedis with malignant melanoma

Objective To investigate the surgical resection and reparation of planta pedis with malignant melanoma.Methods 16 patients(including 10 males and 6 females) with malignant melanoma were treated from July 1999 to February 2008.Extensive resection was performed in all cases.The skin and soft tissues defects of foot were repaired by applying plantar medial flaps with neurovascular pedicles.Results The surgical reparation was successful in all 16 cases.The patients were followed up from 6 months postoperation to 5 years,and all of them remained alive without the recurrence of tumor.Conclusion Local extensive resection is essential for the planta pedis with malignant melanoma.,and satisfactory clinical outcome is achieved by applying the plantar medial flaps with neurovascular pedicles to the skin defects area.