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Immediate Reconstruction for Plantar Melanoma: A Paradigm Shift
Hunter Oliver-Allen1, Merisa Piper, Carolyn Vaughn
1From the Division of Plastic Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA.
Annals of Plastic Surgery
|April 12, 2017
Summary
Immediate reconstruction after wide local excision for plantar melanoma (a type of skin cancer on the foot) is oncologically safe. This approach may reduce patient morbidity compared to delayed reconstruction.
Area of Science:
- Dermatology
- Surgical Oncology
- Plastic Surgery
Background:
- Plantar melanoma traditionally treated with wide local excision and delayed reconstruction.
- Delayed reconstruction involves prolonged wound care and additional surgery.
- Limited data exists on immediate reconstruction for plantar melanoma.
Purpose of the Study:
- To evaluate the safety and outcomes of immediate reconstruction following wide local excision for plantar melanoma.
- To compare immediate reconstruction outcomes with historical data for delayed reconstruction.
Main Methods:
- Retrospective review of 38 patients with plantar melanoma undergoing wide local excision and immediate reconstruction (1999-2014).
- Data collected included patient demographics, reconstruction type, complications, reoperations, and oncologic outcomes.
- Follow-up averaged 34 months.
Main Results:
- Skin grafts were the most frequent reconstruction method.
- Only one major complication (skin graft loss) occurred, requiring reoperation.
- The recurrence rate was 21% (8/38 patients), comparable to published data.
Conclusions:
- Immediate reconstruction for plantar melanoma is oncologically safe.
- This technique offers comparable recurrence rates to delayed reconstruction.
- Immediate reconstruction may decrease overall patient morbidity.