악성 흑색종 치료를 위한 피판술의 임상적 결과

The Clinical Outcome of Flap Coverage for the Treatment of Malignant Melanoma

  • 전우주 (고려대학교 정형외과학교실) ;
  • 강종우 (고려대학교 정형외과학교실) ;
  • 김일환 (고려대학교 피부과학교실) ;
  • 손길수 (고려대학교 외과학교실) ;
  • 박종웅 (고려대학교 정형외과학교실)
  • Jeon, Woo-Joo (Department of Orthopaedic Surgery, College of Medicine, Korea University) ;
  • Kang, Jong-Woo (Department of Orthopaedic Surgery, College of Medicine, Korea University) ;
  • Kim, Il-Hwan (Department of Dermatology, College of Medicine, Korea University) ;
  • Son, Gil-Soo (Department of Surgery, College of Medicine, Korea University) ;
  • Park, Jong-Woong (Department of Orthopaedic Surgery, College of Medicine, Korea University)
  • 발행 : 2010.11.30

초록

In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.

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