An analysis of cheek reconstruction after tumor excision in patients with melanoma.

BACKGROUND: The most common site for melanoma occurrence is the cheek region, and the treatment of melanoma requires extensive local excision. This study evaluated factors that influence the selection of reconstructive procedures after excision of a cheek melanoma.

METHODS: A total of 26 cases (12 with skin grafts, 7 with local flaps, and 7 with free flaps) were included in the study. Factors in the selection of reconstructive procedures were evaluated by examining the size of the skin defects, patient age, and prognosis.

RESULTS: Free flaps were frequently used in cases with large areas of skin defect and with thicker melanomas. Skin grafts were used for a wide variety of tumor thicknesses and for older patients with thick melanomas (due to the general condition of the patients). The dividing line of the range of skin defects between local and free flaps was approximately 40 cm. Reconstruction procedures had no impact on prognosis.

CONCLUSIONS: In deciding on a reconstruction procedure after the excision of a cheek melanoma, 3 factors are important: the range of the skin defect, the severity of the melanoma, and the age of the patient.