Luo Xian Yan, Hu Yong, Yang Wen Jia, Song Xiu Zu, Peng Jian Zhong
All authors are affiliated with the Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, China.
Dermatol Surg. 2024 Oct 1;50(10):908-912. doi: 10.1097/DSS.0000000000004245. Epub 2024 May 28.
Serial excision remains the most commonly used surgical procedure for treating congenital melanocytic nevus (CMN). It is critical to remove as much of the lesion as possible with each procedure to reduce the number of procedures and to shorten the treatment duration.
To investigate the clinical efficacy of W-plasty serial excision for the repair of postoperative CMN defects.
A retrospective analysis of patients with medium CMN was conducted from April 2018 to March 2022. Treatment options were divided into elliptical serial excision (10 cases) and W-plasty serial excision (10 cases).
Follow-up occurred over 6 months. The number of elliptical excision procedures was 2 to 4 (mean 2.9). The scar-to-lesion length ratio was 1.5 to 2.0 (mean 1.7). The mean Vancouver Scar Scale (VSS) score was 5.40 ± 0.42. The number of W-plasty excision procedures was 2 to 3 (mean 2.2). The scar-to-lesion length ratio was 1.2 to 1.5 (mean 1.4). The mean VSS score was 2.70 ± 0.26. W-plasty excision was superior to elliptical excision regarding the number of procedures and the effect on postoperative scars.
W-plasty serial excision can be considered a suitable option for the excision of medium CMN, leading to excellent results.
连续切除仍然是治疗先天性黑素细胞痣（CMN）最常用的外科手术。每次手术尽可能多地切除病变对于减少手术次数和缩短治疗时间至关重要。
探讨W形皮瓣连续切除修复CMN术后缺损的临床疗效。
对2018年4月至2022年3月的中度CMN患者进行回顾性分析。治疗方案分为椭圆形连续切除（10例）和W形皮瓣连续切除（10例）。
随访6个月以上。椭圆形切除手术次数为2至4次（平均2.9次）。瘢痕与病变长度比为1.5至2.0（平均1.7）。温哥华瘢痕量表（VSS）平均评分为5.40±0.42。W形皮瓣切除手术次数为2至3次（平均2.2次）。瘢痕与病变长度比为1.2至1.5（平均1.4）。VSS平均评分为2.70±0.26。在手术次数和对术后瘢痕的影响方面，W形皮瓣切除优于椭圆形切除。
W形皮瓣连续切除可被认为是切除中度CMN的合适选择，效果良好。
