Versatility and safety of flap coverage for wide excision of cutaneous melanomas.

This study is a retrospective analysis of a consecutive series of 85 patients with primary melanomas of the trunk (51 patients) and extremities (34 patients) treated by wide excision and flap repair. Both the standard rhombic flap (39 cases) and the double-Z rhomboid flap (46 cases) were used. Postoperative follow-up was 11 to 49 months, with a mean of 20 months. Major postoperative flap necrosis was encountered in one case (1.1 percent). There were no local recurrences and only one instance of intransit metastasis. As compared with skin grafts, flap repairs were found to be free of the classic contour defect. In this series, flap repair also permitted earlier mobilization and resulted in shorter hospital stays.