Abstract
Melanomas affect the foot and ankle region and are associated with a poor prognosis. The aim of the current study was to evaluate the functional and oncological outcomes of salvage surgery using cutaneous flaps for soft tissue reconstruction of the foot and ankle following the extended resection of a melanoma. A retrospective review was conducted to evaluate patients who presented with foot melanoma and underwent salvage surgery and defect reconstruction using three types of cutaneous flap (group S) or amputation (group A) between January 1999 and December 2010 at the First Hospital of Jilin University (Changchun, China). The postoperative mortality, surgical complications, functional outcomes and oncological outcomes were evaluated. Of the 21 patients, 11 were enrolled into group S and 10 were enrolled into group A. The median follow-up time of the patients was 58 months (range, 6–92 months). In group S, a reverse sural neurocutaneous island flap was used in six patients to perform the foot reconstruction, medial plantar flaps were used in four patients and lateral malleolus flaps were used in one patient. All 11 cutaneous flaps survived and provided satisfactory coverage. Only one cutaneous flap showed partial necrosis and required treatment comprising of debridement and regular changes to the wound dressing. The overall survival rate of patients was 65.0% and patients in the two groups experienced similar oncological outcomes. Salvage surgery with cutaneous flap reconstruction was found to be a reliable option for patients presenting with malignant melanoma of the foot and ankle.
Highlights
Melanoma is a malignant tumor that is derived from melanin‐producing melanocytes
Among 21 patients, males outnumbered females at a ratio of 2:1, previous studies revealed that melanoma may be more prominent in females [15]
Few studies have investigated the benefits of salvage surgery using cutaneous flap reconstruction for the treatment of foot melanoma
Summary
Melanoma is a malignant tumor that is derived from melanin‐producing melanocytes. The treatment of malignant melanoma varies depending on the tumor characteristics (for example, the stage or site). With the progress of microsurgical reconstruction, limb salvage surgery using soft tissue reconstruction has recently emerged as a potential alternative for resectable malignant tumors of the extremities. Large, complex soft tissue defects often remain following tumor excision, which are difficult to reconstruct due to the exposure of the bones, joints and tendons. Foot melanoma remains a challenge to surgeons who are required to consider the oncologic resection whilst preserving limb function (including, walking, moving and other weight‐bearing activities). The availability of a safe, easy and reliable reconstructive option is required to repair the foot in the region of the melanoma. An ideal option would guarantee the complete removal of the tumor as well as preservation of the unique functions of the foot and ankle
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