Plantar flap reconstruction for acral lentiginous melanoma.
BACKGROUND
Acral lentiginous melanoma continues to be difficult to diagnose despite an overall trend toward early identification of smaller and thin lesions. The insidious nature of this lesion often precludes primary closure of the surgical defect once it is excised, adding to the reconstructive complexity. Local flaps on the plantar foot offer an option for reconstruction when the defect is of intermediate size.


METHODS
Eight patients (5 men and 3 women, with an average age of 58 years) who underwent plantar flap reconstruction for defects isolated to the weight-bearing heel were retrospectively reviewed.


RESULTS
The average depth of the melanoma was 2.82 mm. Surgical margins were 2 cm or less in seven of the eight patients. Partial flap necrosis occurred in one patient, and loss of part or all of the skin grafts was noted in two patients. Currently five patients are alive with no evidence of disease.


CONCLUSIONS
The plantar flap can provide local well-vascularized tissue for weight-bearing areas where skin grafting alone may not be appropriate. Coverage of these areas with well-padded flaps led to ambulation in all of the patients studied. We believe this flap offers durable coverage for medium-sized defects in acral lentiginous melanoma.
Evans
G R
GR
Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Friedman
J
J
Shenaq
J
J
Mosser
S
S
D005260:Female; D006365:Heel / Q000601:surgery*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D016896:Treatment Outcome