Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawaharacho, Sakyou-ku, Kyoto 606-8507, Japan.
J Plast Reconstr Aesthet Surg. 2013 Aug;66(8):e229-33. doi: 10.1016/j.bjps.2013.03.018. Epub 2013 Apr 11.
We present an ultra-long followed-up case in which an artificial dermis was used for the treatment of a giant naevus. A 5-year-old boy had a giant naevus on his lower back and both buttocks. The light black pigmentation extended to the lower abdomen and both upper thighs. The lesions on the lower back and both buttocks were treated using the artificial dermis Pelnac in three operative series every 2 years. After removal of the lesion, Pelnac was placed onto the skin defect. Three weeks postoperatively, the silicone film was peeled off and a thin split-thickness skin graft (STSG) taken from the upper-middle back was placed on the regenerated dermis-like connective tissue. Thin STSGs were harvested from the same upper back area repeatedly. The lesions on both posteromedial upper thighs and the lower abdomen were treated in three operative series using tissue expanders. Finally, tissue expanders were inserted subcutaneously in both buttocks where Pelnac had been used 5 years or 7 years before. The lesions around the anus were reconstructed using the expanded skin and local skin flaps. Twenty-two years after the first operation, both grafted and donor sites keep good condition not only cosmetically but also functionally.
我们报告了 1 例超长随访病例，该病例采用人工真皮治疗巨大黑素细胞痣。1 名 5 岁男童，下背部及双侧臀部有巨大黑素细胞痣，浅黑色色素沉着延伸至下腹部及双侧大腿上部。采用人工真皮 Pelnac 先后 3 次手术治疗，每次间隔 2 年。切除病变后，将 Pelnac 覆盖于皮肤缺损处。术后 3 周，剥除硅胶膜，取自中上背部的薄刃厚皮片（split-thickness skin graft，STSG）移植于再生的真皮样结缔组织上。反复从同一背部区域切取薄的 STSG。采用组织扩张器先后 3 次手术治疗双侧大腿后内侧及下腹部病变。最后，在曾使用 5 年或 7 年前人工真皮的双侧臀部皮下置入组织扩张器。利用扩张后的皮肤和局部皮瓣重建肛门周围病变。首次手术后 22 年，移植皮瓣和供皮区不仅外观良好，而且功能正常。
