CAJ | 학술논문

目的：研究足跟恶性黑色素瘤患者，行手术扩大切除并行皮瓣修复后的临床疗效。方法对21例足跟黑色素瘤患者，行距黑色素瘤缘2 cm区域的扩大切除术，并根据足跟皮肤的缺损大小、位置，分别选用带血管神经蒂的足外侧皮瓣、足底内侧岛状皮瓣和腓肠神经营养血管逆行皮瓣移位修复皮肤缺损区，手术前后均配合应用大剂量干扰素治疗。结果术后1例足内侧皮瓣局部皮缘坏死，经后期换药后愈合；其余皮瓣全部成活，切口Ⅰ期愈合。随访6个月～2年，患者均健在，肿瘤未见复发，足跟部皮瓣形态、感觉、色泽、耐磨性、痛觉及功能均满意。结论在治疗足跟部恶性黑色素瘤时应选用足外侧皮瓣、腓肠神经营养血管逆行皮瓣以及足底内侧皮瓣进行皮瓣修复。
목적：연구족근악성흑색소류환자，행수술확대절제병행피판수복후적림상료효。방법대21례족근흑색소류환자，행거흑색소류연2 cm구역적확대절제술，병근거족근피부적결손대소、위치，분별선용대혈관신경체적족외측피판、족저내측도상피판화비장신경영양혈관역행피판이위수복피부결손구，수술전후균배합응용대제량간우소치료。결과술후1례족내측피판국부피연배사，경후기환약후유합；기여피판전부성활，절구Ⅰ기유합。수방6개월～2년，환자균건재，종류미견복발，족근부피판형태、감각、색택、내마성、통각급공능균만의。결론재치료족근부악성흑색소류시응선용족외측피판、비장신경영양혈관역행피판이급족저내측피판진행피판수복。
Objective To study the curative effect of the reparation heel with malignant melanoma after extended resection. Methods 21 patients with malignant melanoma were treated. Enlarged operation was The malignant melanoma was performed 2cm away from the margin of the malignant melanoma. Lateral pedal skin flap,plantar medial artery island skin flap,and retrograde skin flap supplied by sural nutrition blood vessel were respectively applied in the reparation according to the size of heel soft tissue defect. The treatment with interferon was delivered before and after the operation. Results One case had marginal necrosis of plantar medial artery island skin flap;the other flaps survived and incisions healed by first intention. All the surgical reparation was successful in all 21 patients. The post operative follow-up was conducted from 6 months to 4 years. All patients remained alive and no tumor recurrence was observed. Considering the recovery of the function and sense, the flap shape,feeling, color,abradability,algaesthesis and function were good. Conclusion Enlarged operation 2cm away from the margin of the malignant melanoma is essential for the malignant melanoma of the heel. Satisfactory clinical outcome is achieved by using lateral pedal skin flap,plantar medial artery island skin flap,and retrograde skin flap supplied by sural nutrition blood vessel.