Reconstruction using a perforator free flap after malignant melanoma resection of the ankle and foot

Abstract

BACKGROUND: Surgical excision with adequate margin is the treatment of choice to provide best chance for survival. However, tumors located on distal lower extremity may require reconstruction to salvage the limb which may affect prognosis and quality of life. This retrospective study aimed to evaluate the effect of free flap on overall outcomes of patients with primary malignant melanoma located on the foot and ankle.

METHODS: Patients with primary malignant melanoma on the leg and foot who required free flap coverage between August 2005 and January 2014 were evaluated. The reconstruction and oncological outcomes were assessed.

RESULTS: The cohort of 59 patients showed 96.7% successful reconstructive outcomes. The mean duration from surgery to partial weight bearing was 9 days. The 5-year overall survival and 5-year progression-free survival rates were 73.2% and 44%, respectively. The overall VAS-FA score was 94.1 implying excellent functional recovery.

CONCLUSION: The use of free flaps to close defects after cancer resection can help preserve maximal extremity length and function. This approach does not have negative impact on overall outcome and further provide an increased quality of life with better function. Reconstruction using free flaps should be considered primarily when defects cannot be covered by conventional methods.