The Study Of Flap Application In The Limb Salvage Surgery For The Malignant Melanomas In The Foot And Ankle

Abjective：According to the summarization of the clinic data and long term follow upof the patients with malignant melanoma in the foot and ankle that happened in ourdepartment between1999and2010,we aim to compare the treatment effectiveness and longterm survival rate with different kind of flaps; discuss the better therapy plan for patientswith malignant melanoma in the foot and ankle; accumulate the clinical experience;andprovide the theoretic and technical support for the treatment of relative diseases.Methods：There were21patients with malignant melanomas in the foot and anklecoming to our department for treatment in total between1999and2010.According to theanalysis and summarization of the clinical data, the long term follow up of survival, themetastasis or recurrence and the growth and the feeling of the flaps,we evaluate thepossibility to cure the malignant melanomas in the foot and ankle by wide excision and flapreconstruction.Result：We have found the long term effectiveness of this treatment plan byreviewing the clinical datas and follow up:(1)All of the pathological sections provethat the final diagnosis are malignant melanoma and there were no cancer cells in thecutting edge.(2) Seven deaths (one died of heart disease and three had had lymphaticmetastasis in the inguinal lymph nodes already when they came to see the doctor,then distant metastasis,the other three had recurrence and metastasis six months,thirteen months and twenty-two months after the operations)(3)All the flaps growthswell, wear-resisting and most of them possess the protective feelings (4).All thepatients say that they have no difficulty in walking or shoes wearing in their dailylife.Conclusion：(1).The early stage of malignant melanomas in the foot and anklecan be totally cleared up by wide excision, and there is no symptom showing that therate of recurrence or metastasis rise,and it has meaningful clinic significance.(2).Flapsurgery can solve the problem of soft tissue defect after the tumor excision.It canmake a very good repair both in the appearance and function.(3).For the early stage of malignant melanoma in the foot and ankle,the treatment of wide excision and flapsurgery for the soft tissue defect promise a high success opportunity of limb salvage.It will be better when thermotherapy and biotherapy are used.(4).The limb salvagesurgery not only retain the body parts in the greatest degree, but also help alleviatethe financial burden and psychological burden of patients,and speed up the recovery.