Objective To investigate the selection of surgical methods and curative effect of plantar melanoma.

Methods We collected the clinical data of 91 patients with plantar melanoma from March 2011 to December 2017. The advantages and disadvantages of various surgical methods were investigated. The relationship of the operation methods, gender, stage, adjuvant therapy, primary tumor diameter with survival rate of patients was analyzed.

Results Skin grafts were used to repair the wound in non-weight-bearing area of plantar. The peracentage of grafted skins which survived by first intention reached 86% and there were few postoperative complications. There was no significant difference in healing rate, necrosis rate or infection rate among the sural neurovascular flap, saphenous neurovascular flap, medial plantar artery flap and free anterolateral femoral flap, while patients with free anterolateral femoral flap had shorter avenage length of stay after operation. The 5-year survival rate after surgery was 67%. The 5-year survival time was not affected by operation and gender. The 5-year survival rates of patients with stage Ⅱ and Ⅲ were 85.0% and 40.2%, respectively. The survival rates of patients with tumor size≥3 cm and < 3 cm were 60.6% and 83.5%, respectively. The 5-year survival rate of patients with and without adjuvant therapy was 72.0% and 51.6%, respectively.

Conclusion For plantar melanoma patients, skin grafting, sural neurotrophic vascular flap, saphenous neurotrophic vascular flap, medial plantar artery flap and free anterolateral femoral flap could be selected individually to repair surgical wounds after primary resection with good appearance and function and satisfied long-term effect.