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KMID : 1143020220270030240
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Archives of Hand and Microsurgery
2022 Volume.27 No. 3 p.240 ~ p.246
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Long-term results of wide local excision with concurrent venous free flap reconstruction in subungual melanoma
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Woo Soo-Jin
Ma I Zhen
Kwon Sung-Tack
Park Seong-Oh
Kim Byung-Jun
Hong Ki-Yong
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Abstract
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Purpose: Wide local excision (WLE) has been used as an alternative to amputation for preserving the length of the digit in subungual melanoma (SUM). For reconstruction, a free flap could be a more suitable option than a skin graft or a local flap. We investigated the clinical value of WLE with concurrent venous free flap reconstruction in SUM located on the finger and toe.
Methods: Seventeen patients underwent WLE with a concurrent arterialized venous free flap between January 2011 and December 2015. Venous flaps were harvested from the forearm or foot dorsum and inset using a through- or against-valve type.
Results: The mean tumor area was 1.3±0.9 cm2, and the mean resection margin was 5.6±2.3 mm. In histologic analyses, the mean tumor thickness was 1.2±1.1 mm. The mean duration of the follow-up period was 75.5 months. Three patients had local recurrence and one patient had distant metastasis. Reconstruction of the fingers and toes using a venous flap was effective and could be performed without major complications. Patients were satisfied with the functional and aesthetic results.
Conclusion: WLE provides an acceptable local control rate and offers a safe and conservative alternative for the treatment of SUM of the fingers and toes. Concurrent venous free flaps could be a desirable option for aesthetic and functional reconstruction.
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KEYWORD
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Melanoma, Free flap
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