Suh Young C, Suh Hyunsuk P, Lee Jong S, Chang Jee S, Hong Joon P Jp
Department of Plastic and Reconstructive Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
J Surg Oncol. 2017 Dec;116(7):862-869. doi: 10.1002/jso.24736. Epub 2017 Jun 26.
Surgical excision with adequate margin is the treatment of choice to provide best chance for survival. However, tumors located on distal lower extremity may require reconstruction to salvage the limb which may affect prognosis and quality of life. This retrospective study aimed to evaluate the effect of free flap on overall outcomes of patients with primary malignant melanoma located on the foot and ankle.
Patients with primary malignant melanoma on the leg and foot who required free flap coverage between August 2005 and January 2014 were evaluated. The reconstruction and oncological outcomes were assessed.
The cohort of 59 patients showed 96.7% successful reconstructive outcomes. The mean duration from surgery to partial weight bearing was 9 days. The 5-year overall survival and 5-year progression-free survival rates were 73.2% and 44%, respectively. The overall VAS-FA score was 94.1 implying excellent functional recovery.
The use of free flaps to close defects after cancer resection can help preserve maximal extremity length and function. This approach does not have negative impact on overall outcome and further provide an increased quality of life with better function. Reconstruction using free flaps should be considered primarily when defects cannot be covered by conventional methods.
手术切除并保证切缘足够是提供最佳生存机会的首选治疗方法。然而，位于下肢远端的肿瘤可能需要进行重建以挽救肢体，这可能会影响预后和生活质量。这项回顾性研究旨在评估游离皮瓣对足部和踝部原发性恶性黑色素瘤患者总体预后的影响。
对2005年8月至2014年1月期间因原发性恶性黑色素瘤位于腿部和足部而需要游离皮瓣覆盖的患者进行评估。评估重建和肿瘤学预后。
59例患者队列显示重建成功率为96.7%。从手术到部分负重的平均时间为9天。5年总生存率和5年无进展生存率分别为73.2%和44%。VAS-FA总评分94.1，意味着功能恢复极佳。
癌症切除后使用游离皮瓣闭合缺损有助于保留最大肢体长度和功能。这种方法对总体预后没有负面影响，还能通过更好的功能进一步提高生活质量。当缺损无法用传统方法覆盖时，应首先考虑使用游离皮瓣进行重建。
