【摘要】 目的 探讨带蒂足底内侧皮瓣修复足部雀斑样痣型恶性黑色素瘤（Acral Lentiginous Melanoma,ALM）术后创面的临床效果。方法 回顾性分析2018年1月-2021年12月接受肿瘤扩大切除联合带蒂足底内侧皮瓣修复的7例TNM分期Ⅰ～Ⅲ期ALM患者资料。术中采用“同心圆”扩大切除（切缘距肿瘤2.0～3.0 cm），设计以足底内侧动脉为蒂岛状皮瓣修复创面，供区直接缝合或植皮。结果 7例皮瓣均成活，供受区一期愈合，术后3个月AOFAS评分由（32.5±6.2）分提升至（88.3±5.4）分（P<0.001），疼痛评分由术前（7.2±2.1）分降至（1.5±0.8）分（P<0.001）。随访1～3年，1例Ⅲ期患者出现肺转移，其余无复发，1年、3年生存率分别为100%、85.7%。结论 带蒂足底内侧皮瓣修复ALM术后创面安全有效，可保留足部功能及感觉，适合临床推广。更多还原

【Abstract】 Objective To investigate the clinical effect of repairing postoperative wounds of acral lentiginous melanoma(ALM) of the foot with pedicled medial plantar flap. Methods A retrospective analysis was performed on the data of 7 ALM patients who underwent tumor extended resection combined with pedicled medial plantar flap repair from January 2018 to December 2021. During surgery, “concentric circle” extended resection was used(the resection margin was 2.0～3.0 cm from the tumor), and an island flap with the medial plantar artery as the pedicle was designed to repair the wound. The donor site was directly sutured or skin-grafted. Results All 7 flaps survived, and the donor and recipient sites healed by first intention. At 3 months postoperatively, the AOFAS score increased from(32.5±6.2) points to(88.3±5.4) points(P <0.001), and the pain score decreased from(7.2±2.1) points preoperatively to(1.5±0.8) points(P <0.001). During the follow-up period of 1-3 years, lung metastasis occurred in 1 stage Ⅲ patient, and no recurrence was found in the others. The 1-year and 3-year survival rates were 100% and 85.7%,respectively. Conclusion Repairing postoperative wounds of ALM with pedicled medial plantar flap is safe and effective, which can preserve foot function and sensation, and is suitable for clinical promotion.更多还原