Reconstruction of Calcaneous Region after Melanoma Excision with Extended Medial Plantar Flap: Case ReportPaulo Rocha de Pádua Júnior1*, Fernando Henrique Novaes1, Vinicius Costa Souza2 and Guilherme Barreiro Cardinali1
- *Corresponding Author:
- Paulo Rocha de Pádua Júnior
Department of Plastic Surgery and Burns
State Public Hospital Hospital, Vila Clementino, Brazil
E-mail: [email protected]
Received date: May 30, 2017; Accepted date: June 08, 2017; Published date: June 15, 2017
Citation: Júnior PRDP, Novaes FH, Souza VC, Cardinali GB (2017) Reconstruction of Calcaneous Region after Melanoma Excision with Extended Medial Plantar Flap: Case Report. J Surg Anesth 1:103.
Copyright: © 2017 de Pádua PR Jr., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Acral melanoma has some distinct characteristics of the other melanoma subtypes as a higher frequency of local involvement. This leads to surgical treatment with wide margins of deep and peripheral resection, causing significant tissue loss with frequent exposure of the bone ends. The medial plantar flap uses the skin of the plantar cavus area, an ideal tissue for reconstruction of the calcaneous area.
Objective: To report a case of calcaneal region reconstruction with medial plantar flap after melanoma excision.
Case report: Patient, female, had a lesion diagnosed on the right foot in medical consultation due to unicomycosis. There were no complaints related to the injury. The biopsy revealed malignant acral lentiginous melanoma with a Breslow thickness of 1.9 mm, surgical margins free of neoplastic involvement and T2NxMx pathological staging. After the anatomopathological result, a 2 cm margin magnification was programmed with extensive resultant defect. The plastic surgery team opted for immediate reconstruction with ipsilateral extended medial plantar flap and graft of the donor area.
Conclusion: The medial plantar flap provides adequate coverage for the calcaneal region, resistant to local inherent traumas of the region, with low morbidity in the donor area, good esthetic effect, rare complications, easy reproducibility and satisfactory functional recovery. It can be extended including a lateral plantar artery depending on the case, besides being able to remove the graft from the flap itself to avoid an increase in morbidity in other areas.