Hayashi Toshihiko, Furukawa Hiroshi, Oyama Akihiko, Funayama Emi, Saito Akira, Yamamoto Yuhei
From the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
J Craniofac Surg. 2014;25(2):e98-101. doi: 10.1097/SCS.0000000000000397.
The most common site for melanoma occurrence is the cheek region, and the treatment of melanoma requires extensive local excision. This study evaluated factors that influence the selection of reconstructive procedures after excision of a cheek melanoma.
A total of 26 cases (12 with skin grafts, 7 with local flaps, and 7 with free flaps) were included in the study. Factors in the selection of reconstructive procedures were evaluated by examining the size of the skin defects, patient age, and prognosis.
Free flaps were frequently used in cases with large areas of skin defect and with thicker melanomas. Skin grafts were used for a wide variety of tumor thicknesses and for older patients with thick melanomas (due to the general condition of the patients). The dividing line of the range of skin defects between local and free flaps was approximately 40 cm. Reconstruction procedures had no impact on prognosis.
In deciding on a reconstruction procedure after the excision of a cheek melanoma, 3 factors are important: the range of the skin defect, the severity of the melanoma, and the age of the patient.
黑色素瘤最常见的发生部位是颊部,黑色素瘤的治疗需要广泛的局部切除。本研究评估了影响颊部黑色素瘤切除术后重建手术选择的因素。
本研究共纳入26例患者(12例行皮肤移植,7例行局部皮瓣,7例行游离皮瓣)。通过检查皮肤缺损大小、患者年龄和预后评估重建手术选择的因素。
游离皮瓣常用于皮肤缺损面积大及黑色素瘤较厚的病例。皮肤移植用于各种肿瘤厚度的病例以及黑色素瘤较厚的老年患者(由于患者的一般状况)。局部皮瓣和游离皮瓣的皮肤缺损范围分界线约为40平方厘米。重建手术对预后无影响。
在决定颊部黑色素瘤切除术后的重建手术时,三个因素很重要:皮肤缺损范围、黑色素瘤的严重程度和患者年龄。