Medial plantar island flap for soft tissue reconstruction of the heel after excision of melanoma

Abstract

Objective To study the efficacy of medial plantar island flap for repairing soft tissue defect of the heel after excision of melanoma. Methods Five patients (including 3 males and 2 females) with malignant melanoma were treated. All lesions were located in the heel and were proved by pathological examination. Local extensive resection was performed in all cases. The surgical margin used for excision of melanoma was 2 cm, and the depth used was deep into periosteum of the calcaneus. Plantar medial artery island skin flaps were applied in the reparation according to the size of heel soft tissue defect and anatomic study. The postoperative follow-up was 8 to 14 months. Results The surgical reparation was successful in all 5 cases. The plantar medial artery was very suitable to cover the surgical wound surface and to recover the function and sense. Before 3 months the sense of flaps remained on the donor area and later went to the heel gradually. All patients remained alive and no tumor recurrence was observed. All the patients were walking normally and had protective sensation in the new heel pad comparable to the opposite normal heel. Two patients with more than 10 years follow-up were reported. Conclusions Plantar medial island flap can be used to repair the wound after malignant melanoma resection in the heel, which is an effective method. Key words: Malignant melanoma; Heel; Island flap; Medial plantar artery