股前外游离皮瓣修复足跟恶性黑色素瘤术后缺损疗效观察

The curative effect of anterolateral thigh flap in repairing defect caused by resection of malignant melanoma in the heel region

目的 观察股前外侧游离皮瓣修复足跟恶性黑色素瘤术后缺损的疗效。方法收集足底恶性黑色素瘤8例，均在术中行肿瘤切除送快速冰冻病理活检进一步确诊，缺损区采用股前外游离皮瓣修复。结果术后皮瓣均成活，术后1个月后恢复正常行走。半年后皮瓣感觉功能恢复良好，与健侧足底比较触觉、振动觉和温度觉均接近正常。所有患者均获随访，随访时间0．5—3年，8例患者均未出现局部复发、远位转移。结论采用股前外侧游离皮瓣修复足跟恶性黑色素瘤扩大切除术后剩余组织量较少的缺损，皮瓣能负重、耐磨，减少过冷过热损伤，且切除范围可以不受局部皮瓣的限制，临床疗效满意。

Objective To observe the clinical effect of the anterolateral thigh flap in repairing defect caused by resection of malignant melanoma in the heel region. Methods 8 patients with heel malignant melanoma were treated by surgery. The malignant melanoma was further diagnosed by histopathological examination. Their heel defects caused by large resection of malignant melanoma were treated by anterolateral thigh flap. Results All skin flaps survived and all the patients could walk normally 1 month after operation. The recovery of the function and sense was well 6 months after operation. Compared with the another well heel, the flaps had normal texture, color and appearance of heel. 8 patients had complete follow - up, ranged form 6 months to 3 years. All cases survived with neither local recurrence nor distant metastasis. Conclusion The anterolateral thigh flap can achieve good clinical effect in treating heel defect caused by the resection of malignant melamoma. And especially apply in large skin and tissue defect of heel area. The flap can weight, wear - resisting and reduce overheating and over cold damage. The range of resection can not be restricted by local skin flap. The clinical effect is satisfied.