面部皮肤恶性黑色素瘤整复治疗的临床观察

目的 探讨治疗面部皮肤恶性黑色素瘤切除后皮肤缺损的手术方法 ，并评价其临床疗效。方法 2007年2月至2014年3月本科收治9例面部皮肤恶性黑色素瘤，均采用手术扩大切除病灶；术中常规冰冻切片监测手术切缘，病灶切除后皮肤软组织缺损，分别采用游离皮片移植2例，邻近任意皮瓣6例，游离皮瓣1例，术后常规辅以免疫治疗。结果 9例皮片及皮瓣均成活，伤口Ⅰ期愈合。局部形态较好，术区平整，瘢痕不明显。9例患者获随访3个月~7年，死亡2例，其中1例因其他疾病术后2年死亡；其余病例外形良好，未见局部复发。结论 面部皮肤恶性黑色素瘤手术治疗联合术后辅助免疫治疗疗效肯定，皮瓣修复可取得较为理想的局部外形，术中常规冰冻切片是保证肿瘤根治的一项重要手段。

Plastic surgical treatment and evaluation for cutaneous malignant melanoma of face

Objective To investigate the effects of surgical method for cutaneous malignant melanoma of face after surgical ablation. Methods From February 2007 to May 2014，9 patients with cutaneous malignant melanoma of face were treated in our department. All the wounds were excised totally. Intraoperative frozen section was performed in order to monitor border line of tumor. The wounds were repaired by local flaps in 6 patients， full-thickness skin grafting in 2 patients，and free skin flap in 1 patient. Immunotherapy was selected as an accessory treatment after surgical ablation. Results Of 9 cases，the skin flap or skin grafts healed primarily. The appearance appeared very good in all cases after repair. Nine patients were followed up respectively from 3 months to 7 years post operation， and 2 patients died（among them， one patient died from other diseases）. No recurrence was found in other patients. Conclusion The effect of surgical treatment and immunotherapy for cutaneous malignant melanoma of face are sure. Free flap and local flap for repairing the facial skin defect can restore ideal appearance. It is an important method for radical dissection by intraoperative frozen section.