Skin-Fat Composite Grafts after Excisions of Medium Sized Congenital Melanocytic Nevi in Children.
10.14730/aaps.2015.21.2.59
- Author:
Dae Hwa KIM
1
;
Il Hwan BYUN
;
Dae Hyun LEW
;
Won Jai LEE
Author Information
1. Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea. pswjlee@yuhs.ac
- Publication Type:Original Article
- Keywords:
Nevus pigmented;
Skin transplantation;
Surgical flaps
- MeSH:
Child*;
Cicatrix;
Dermis;
Epidermis;
Follow-Up Studies;
Humans;
Nevus;
Nevus, Pigmented*;
Parents;
Reoperation;
Skin;
Skin Transplantation;
Subcutaneous Fat;
Surgical Flaps;
Tissue Donors;
Transplants*
- From:Archives of Aesthetic Plastic Surgery
2015;21(2):59-64
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Medium-sized congenital melanocytic nevi (CMN) require surgical excision because of the risk of malignant transformation and aesthetic concerns. There are various possible reconstruction methods after excision, such as primary repair, skin graft, local flap, and composite graft. In this study, we used skin-fat composite grafts for reconstructing full-thickness skin defects and assessed the aesthetic outcomes. METHODS: Facial nevi excision plus skin-fat composite grafts were performed in 11 children (range, 3-16 years old). All grafts were harvested from the preauricular area on one or both sides; they included the epidermis, full-thickness dermis, and subcutaneous fat. All procedures were performed simultaneously. Standardized photographs were taken preoperatively and at a mean follow-up of 10.5 months. Viewing the photographs, four plastic surgeons rated the aesthetic outcomes of all patients using the following scale: 1, poor; 2, fair; 3, good; 4, very good; and 5, excellent. RESULTS: No patient was diagnosed with malignancy. There were no complications, such as graft loss, infection, or aesthetic problems that required surgical revision. All donor sites healed well and exhibited only minimal scarring. The aesthetic outcomes of skin-fat composite grafts were outstanding with a mean score of 4.2 +/- 0.4. Most patients and parents were highly satisfied with the results. CONCLUSIONS: Skin-fat composite grafts provide good color match, texture, and contour. They are more tolerable, especially in children, because the technique involves simpler procedures and shorter operation times than local flaps. They may be the ideal option for facial defects after excision of medium-sized melanocytic nevi.
