Abstract
Cutaneous melanoma is a highly malignant skin tumor, and in China, the planta pedis
is a commonly involved site. The sites of plantar melanomas are a challenge to reconstruct
after wide excision. Our experience with surgical management of melanomas was based
on the 4 different anatomic subunits of the planta pedis. From January 1, 2002 to
December 31, 2016, 35 patients who had had plantar melanoma had undergone surgical
treatment in our clinic. The tumor locations were as follows: the toe in 6, the ball
of the foot in 5, the arch in 15, and the heel in 9. Surgical management involved
extended resection of the tumor, repair of defects with skin grafts or flaps, and
inguinal lymphadenectomy. The skin flaps included a residual toe flap, an anterograde
or retrograde medial plantar flap, and a retrograde sural neurocutaneous vascular
flap. Of the 35 cases of flaps and skin grafts, 33 (94.29%) survived, and the wounds
had healed by first intention. After a follow-up period of 6 months to 7 years, 24
patients (68.57%) were free of local and systemic disease and 30 patients (85.71%)
were ambulatory using shoes, and all the flaps and skin grafts showed a good appearance.
The personalized surgical treatments we used for melanoma in the planta pedis resulted
in overall satisfactory outcomes and adequate disease clearance, and allowed the patients
to resume normal lives. The function of the foot was maintained or restored to the
greatest possible degree, and the patients' quality of life improved postoperatively.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: April 06, 2018
Footnotes
Financial Disclosure: This work was supported by the National Natural Science Foundation of China (grant 81272989) and the Science Foundation of Jinling Hospital (grant YYZD2014002 to S.-M.Y.).
Conflict of Interest: None reported.
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© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
