Clin Orthop Surg.  2010 Dec;2(4):244-249. 10.4055/cios.2010.2.4.244.

Soft Tissue Reconstruction of the Foot Using the Distally Based Island Pedicle Flap after Resection of Malignant Melanoma

Affiliations
  • 1Orthopaedic Oncology Clinic, National Cancer Center, Goyang, Korea. docjune@ncc.re.kr
  • 2Department of Orthopaedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
  • 3Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
We report on our experience with using a distally based island flap for soft tissue reconstruction of the foot in limb salvage surgery for malignant melanoma patients.
METHODS
A distally based sural flap was used for 10 cases for the hindfoot reconstruction, and a lateral supramalleolar flap was used for 3 cases for the lateral arch reconstruction of the mid- and forefoot after wide excision of malignant melanomas.
RESULTS
The length of the flap varied from 7.5 cm to 12 cm (mean, 9.6 cm) and the width varied from 6.5 cm to 12 cm (mean, 8.8 cm). Superficial necrosis developed in four flaps, but this was successfully treated by debridement and suture or a skin graft. All thirteen flaps survived completely and they provided good contour, stable and durable coverage for normal weight bearing.
CONCLUSIONS
The distally based sural flap is considered to be useful for reconstructing the hindfoot, and the lateral supramalleolar flap is good for reconstructing the lateral archs of the mid- and forefoot after resection of malignant melanoma of the foot.

Keyword

Malignant melanoma; Distally based sural flap; Lateral supramalleolar flap

MeSH Terms

Adult
Aged
Female
Foot/*surgery
Foot Diseases/*surgery
*Free Tissue Flaps
Humans
Limb Salvage
Male
Melanoma/*surgery
Middle Aged
Reconstructive Surgical Procedures/methods
Skin Neoplasms/*surgery

Reference

1. Sommerlad BC, McGrouther DA. Resurfacing the sole: long-term follow-up and comparison of techniques. Br J Plast Surg. 1978. 31(2):107–116.
Article
2. Almeida MF, da Costa PR, Okawa RY. Reverse-flow island sural flap. Plast Reconstr Surg. 2002. 109(2):583–591.
Article
3. Kneser U, Bach AD, Polykandriotis E, Kopp J, Horch RE. Delayed reverse sural flap for staged reconstruction of the foot and lower leg. Plast Reconstr Surg. 2005. 116(7):1910–1917.
Article
4. Demiri E, Foroglou P, Dionyssiou D, et al. Our experience with the lateral supramalleolar island flap for reconstruction of the distal leg and foot: a review of 20 cases. Scand J Plast Reconstr Surg Hand Surg. 2006. 40(2):106–110.
Article
5. Voche P, Merle M, Stussi JD. The lateral supramalleolar flap: experience with 41 flaps. Ann Plast Surg. 2005. 54(1):49–54.
Article
6. May JW Jr, Rohrich RJ. Foot reconstruction using free microvascular muscle flaps with skin grafts. Clin Plast Surg. 1986. 13(4):681–689.
Article
7. Clark N, Sherman R. Soft-tissue reconstruction of the foot and ankle. Orthop Clin North Am. 1993. 24(3):489–503.
Article
8. Ferreira MC, Besteiro JM, Monteiro Junior AA, Zumiotti A. Reconstruction of the foot with microvascular free flaps. Microsurgery. 1994;15(1):33-6. 15(1):33–36.
9. Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol. 2001. 19(16):3635–3648.
10. Donski PK, Fogdestam I. Distally based fasciocutaneous flap from the sural region: a preliminary report. Scand J Plast Reconstr Surg. 1983. 17(3):191–196.
Article
11. Hasegawa M Jr, Torii S, Katoh H, Esaki S. The distally based superficial sural artery flap. Plast Reconstr Surg. 1994. 93(5):1012–1020.
Article
12. Masquelet AC, Romana MC, Wolf G. Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: anatomic study and clinical experience in the leg. Plast Reconstr Surg. 1992. 89(6):1115–1121.
Article
13. Torii S, Namiki Y, Mori R. Reverse-flow island flap: clinical report and venous drainage. Plast Reconstr Surg. 1987. 79(4):600–609.
Article
14. Masquelet AC Jr, Beveridge J, Romana C, Gerber C. The lateral supramalleolar flap. Plast Reconstr Surg. 1988. 81(1):74–81.
15. Tan O Jr, Atik B, Bekerecioglu M. Supercharged reverse-flow sural flap: a new modification increasing the reliability of the flap. Microsurgery. 2005. 25(1):36–43.
16. Langstein HN, Chang DW, Miller MJ, et al. Limb salvage for soft-tissue malignancies of the foot: an evaluation of freetissue transfer. Plast Reconstr Surg. 2002. 109(1):152–159.
Article
17. Dubois RW Jr, Swetter SM, Atkins M, et al. Developing indications for the use of sentinel lymph node biopsy and adjuvant high-dose interferon alfa-2b in melanoma. Arch Dermatol. 2001. 137(9):1217–1224.
Article
Full Text Links
  • CIOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2025 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr