Bauer B S, Vicari F A
Division of Plastic Surgery, Children's Memorial Hospital, Chicago, Ill.
Plast Reconstr Surg. 1988 Dec;82(6):1012-21. doi: 10.1097/00006534-198812000-00012.
This paper presents a timely coordinated approach to complete excision of congenital giant pigmented nevi in infancy and early childhood based on a review of 78 patients with giant pigmented nevi of the head and neck, trunk, and/or extremity. Giant pigmented nevi in those selected for review measured from a minimum of 2 percent up to 45 percent total body surface (TBS). Giant nevi of the scalp were treated most effectively using tissue expansion, beginning as early as 3 months of age. Expanded forehead and neck flaps in combination with expanded full-thickness skin grafts were used in early excision of giant pigmented nevi of the face. Giant nevi of the trunk were treated using a combination of abdominoplasty technique, tissue expansion, and split-thickness skin graft, with early "large segment" excision and grafting being the most effective treatment of giant nevi covering the posterior trunk. Giant nevi of the extremities were treated most effectively with excision and graft. Expanded full-thickness skin grafts gave excellent coverage on the hands and feet.
本文基于对78例头颈部、躯干和/或四肢先天性巨大色素痣患者的回顾，提出了一种在婴儿期和幼儿期及时进行先天性巨大色素痣完整切除的协调方法。纳入回顾的患者中，巨大色素痣面积占全身表面积（TBS）的比例最低为2%，最高达45%。头皮巨大色素痣最有效的治疗方法是组织扩张，最早可在3个月大时开始。在面部巨大色素痣的早期切除中，使用扩张的额部和颈部皮瓣联合扩张的全厚皮片。躯干巨大色素痣采用腹部整形技术、组织扩张和中厚皮片移植相结合的方法治疗，早期“大片段”切除并移植是覆盖后躯干巨大色素痣最有效的治疗方法。四肢巨大色素痣最有效的治疗方法是切除并移植。扩张的全厚皮片对手部和足部有很好的覆盖效果。
