Department of Pediatrics, Maternal and Child Health Hospital of Fushun County, Sichuan Province, Fushun, 643200, China.
Department of Pediatrics, First People's Hospital of Zigong City, Sichuan Province, Zigong, 643000, China.
Asian J Surg. 2023 Nov;46(11):4848-4849. doi: 10.1016/j.asjsur.2023.05.131. Epub 2023 Jun 10.
In this study, we retrospectively analyzed the clinical data of a newborn with aplasia cutis congenita (ACC) to provide insights for diagnosing and treating the disease. It is believed that ACC with an intact skull and a skin defect diameter of less than 2 cm can be treated conservatively. The main strategies include local disinfection and regular dressing changes to promote epithelial regeneration. The lesion can heal over weeks or months through epithelization adjacent to the defect tissue, resulting in a healed contracture scar with a smooth, hairless surface that can be surgically removed later. For children with large scalp defects or skull defects, skin transplantation, free flap, and cranioplasty can be performed to repair the wound and restore the tissue structure. It is worth mentioning that although this child had a scalp defect larger than 2 cm, conservative treatment still had a significant effect. This suggests that conservative treatment can be considered as the first choice for ACC neonates without skull defects, and surgical treatment can be considered when necessary.
在这项研究中,我们回顾性分析了一名先天性皮肤发育不全(ACC)新生儿的临床资料,以期为该病的诊断和治疗提供思路。目前认为,直径小于 2cm 且颅骨完整的 ACC 可采取保守治疗,主要策略包括局部消毒和定期换药以促进上皮再生,通过临近缺损组织的上皮化,创面在数周或数月内愈合,遗留的收缩性瘢痕表面光滑无毛,后期可手术切除。对于头皮缺损较大或颅骨缺损的患儿,可进行皮肤移植、游离皮瓣、颅骨修补等方式修复创面,恢复组织结构。值得一提的是,虽然该患儿头皮缺损超过 2cm,但保守治疗仍有显著效果,这提示对于无颅骨缺损的 ACC 新生儿,保守治疗可作为首选,必要时再考虑手术治疗。