You said it yourself: For other type of clothing, you will need make a different mesh that has drastically different topology. Skirts, jackets, high heels, boots. Unless you're asking for something else?
I use it all the time. Its great for quick clothes. and its great for a tshirt or pants to have the same basic topology as your base mesh. edit I do most of my extractions for an animatable mesh in a traditional 3d modeler like silo..but you could use zbrush for sure.