Flook D, Horgan K, Taylor B A, Hughes L E
Br J Surg. 1986 Oct;73(10):793-5. doi: 10.1002/bjs.1800731011.
A study of 186 melanomas requiring skin grafts and followed for 1-13 years has shown no preferential implantation in an ipsilateral donor site, despite standard surgical teaching that skin grafts for melanoma defects should not be taken from the same limb as the primary tumour. Two cases were encountered of preferential metastasis to a distant donor site outside the lymphatic drainage of the melanoma and we present a further case where ipsilateral recurrence simulated donor site recurrence. It is clear that the major mechanism of spread to distant donor sites is by the haematogenous route to an area of acute trauma. Hence it is recommended that where possible donor skin is taken from the same limb as the tumour, so that any preferential metastasis will remain within an area amenable to regional limb perfusion.
一项针对186例需要皮肤移植且随访1至13年的黑色素瘤患者的研究表明，尽管标准外科教学认为黑色素瘤缺损的皮肤移植不应取自与原发肿瘤相同的肢体，但并未发现同侧供皮部位有优先植入现象。遇到两例黑色素瘤淋巴引流区域外远处供皮部位优先转移的病例，我们还介绍了另一例同侧复发模拟供皮部位复发的病例。显然，转移至远处供皮部位的主要机制是通过血行途径到达急性创伤区域。因此，建议尽可能从与肿瘤相同的肢体获取供皮，这样任何优先转移都将局限在适合进行肢体区域灌注的范围内。
