The Department of Plastic Surgery, Jiangsu Provincial Hospital of TCM, 155 Hanzhong Road, Nanjing, PR China.
J Plast Reconstr Aesthet Surg. 2012 Feb;65(2):258-63. doi: 10.1016/j.bjps.2011.06.042. Epub 2011 Jul 27.
Excision of a congenital giant nevus is advised due to the possibility of it degenerating into a malignant melanoma or for aesthetic concerns. Tissue expansion has emerged as the primary treatment of giant congenital nevi because it enables the body to produce extra skin with excellent texture, better colour match, less severe donor-site deformity and repeated usage of an expanding donor-site. We present a multi-staged expansion/local flap technique to treat a case of a circumferential nevus from the acromioclavicular joint and axillary area throughout the upper extremity excluding the hand. The affected skin was approximately 10% of the total body surface area. The patient underwent eight operations and a total of 11 rounds of tissue expansions (500 cc × 9 rounds, 600 cc × 1 round, 300 cc × 1 round) were completed over a 2-year period prior to the removal of the nevus. A good aesthetic and functional outcome in the left upper extremity was gained. It is recommended that the treatment of giant nevi is best if completed at preschool age after taking several factors into consideration.
建议切除先天性巨大痣，因为它有恶变成为恶性黑色素瘤的可能，或者出于美观考虑。组织扩张已成为治疗巨大先天性痣的主要方法，因为它可以使身体产生具有极好质地、更好颜色匹配、更轻微供区畸形和可重复使用的扩张供区的额外皮肤。我们提出了一种多阶段扩张/局部皮瓣技术来治疗一例从肩锁关节和腋窝区域到整个上肢（不包括手）的环状痣。受累皮肤约占体表面积的 10%。患者接受了 8 次手术，在 2 年内共进行了 11 轮组织扩张（500cc×9 轮、600cc×1 轮、300cc×1 轮），然后切除了痣。左侧上肢获得了良好的美学和功能效果。建议在考虑了几个因素后，最好在学龄前完成巨大痣的治疗。
