Hassanein Aladdin H, Couto Javier A, Greene Arin K
Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA.
J Craniofac Surg. 2015 Jul;26(5):1611-2. doi: 10.1097/SCS.0000000000001779.
Standard resection of pediatric facial skin lesions consists of lenticular excision and linear closure. This one-stage procedure for circular lesions results in a linear scar 3 times longer than the diameter of the removed specimen. Circular excision and purse-string closure has been described for infantile hemangiomas to reduce the length of scar. The purpose of this study was to analyze the application of this technique for any type of circular facial skin lesion in the pediatric population. Records of consecutive pediatric patients with facial skin lesions treated with circular excision and purse-string closure from 2007-2014 were reviewed. Patient age, sex, type of lesion, location, and size were recorded. Number of stages necessary to remove the area and complications were analyzed. Seventy-seven children (74% female) underwent circular excision and purse-string closure for an infantile hemangioma (46%), pigmented nevus (27%), Spitz nevus (7%), pilomatrixoma (5%), pyogenic granuloma (5%), vascular malformation (4%), or another type of skin lesion (6%). Age at the time of resection was 6.0 years (range 4 months-17 years) and mean lesion area was 3.9 cm (range 0.2-19.6); 30% of patients underwent a second procedure and no infection or wound dehiscence occurred. Circular excision and purse-string closure is an effective technique to manage any type of circular skin lesion in the pediatric population. It is particularly useful for lesions on the face because it limits the length of a scar. A subset of patients may benefit from second procedure to convert the circular scar from a circle into a line.
小儿面部皮肤病变的标准切除术包括透镜状切除和线性缝合。这种针对圆形病变的一期手术会导致线性瘢痕比切除标本的直径长3倍。对于婴儿血管瘤，已描述采用圆形切除和荷包缝合来减少瘢痕长度。本研究的目的是分析该技术在小儿人群中对任何类型圆形面部皮肤病变的应用。回顾了2007年至2014年接受圆形切除和荷包缝合治疗的小儿面部皮肤病变连续患者的记录。记录患者的年龄、性别、病变类型、位置和大小。分析切除病变所需的分期数和并发症。77名儿童（74%为女性）接受了圆形切除和荷包缝合，病变类型包括婴儿血管瘤（46%）、色素痣（27%）、Spitz痣（7%）、毛母质瘤（5%）、化脓性肉芽肿（5%）、血管畸形（4%）或其他类型的皮肤病变（6%）。切除时的年龄为6.0岁（范围4个月至17岁），平均病变面积为3.9平方厘米（范围0.2至19.6）；30%的患者接受了第二次手术，未发生感染或伤口裂开。圆形切除和荷包缝合是处理小儿人群中任何类型圆形皮肤病变的有效技术。它对面部病变特别有用，因为它限制了瘢痕长度。一部分患者可能受益于第二次手术，将圆形瘢痕转变为线性瘢痕。
