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CC BY 4.0 · Arch Plast Surg 2024; 51(03): 290-294
DOI: 10.1055/a-2201-8061
Pediatric/Craniomaxillofacial/Head & Neck
Case Report

Serial Tissue Expansion and Skin Grafts in the Management of a Giant Congenital Nevus of the Face: Review of Literature and Case Report

Trần Thiết Sơn 
1   Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam
2   Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam
3   Department of Plastic Reconstructive and Aesthetic Surgery, University of Medicine and Pharmacy, Hanoi National University, Hanoi, Vietnam
,
Phan Tuấn Nghĩa 
1   Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam
2   Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam
,
Phạm Thị Việt Dung 
1   Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam
2   Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam
,
Tạ Thị Hồng Thuý 
1   Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam
2   Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam
,
Hoàng Tuấn Anh 
1   Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam
,
Lê Anh Huy 
2   Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam
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Abstract

Giant congenital nevi, especially on the head and neck, pose a challenge for plastic surgeons. This requires extensive experience in detailed planning, combining different techniques, and selecting appropriate materials for reconstruction. There have been reports of using a tissue expander, serial resection method, and full-thickness skin grafts for this type of nevus. However, the best way to completely remove a giant congenital nevus is endless. In this article, we would like to present a case of a left hemifacial giant congenital nevus in which we used multiple tissue expansion to fully replace the nevus, along with some of our modification techniques.

Keywords

giant congenital nevus - tissue expansion - facial nevus - head and neck reconstruction

Authors' Contributions

T.T.S.: Project administration, Conceptualization, Writing—original draft, Writing—review and editing, Resources, Performed the operation. P.T.N.: Writing—review and editing. P.T.V.D.: Investigation, Supervision. T.T.H.T.: Visualization. H.T.A.: Supervision, Methodology. L.A.H.: Writing—review and editing.


Ethical Approval

Ethical approval was given by Institutional Review Board, Hanoi medical university. The reference number: 136/QĐ-ĐHYHN.


Patient Consent

The patient provided written informed consent before enrolment in the report. The privacy and confidentiality of patient records were adhered to in managing the clinical information in conducting this report.




Publication History

Received: 22 May 2023

Accepted: 23 October 2023

Accepted Manuscript online:
31 October 2023

Article published online:
29 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Gur E, Zuker RM. Complex facial nevi: a surgical algorithm. Plast Reconstr Surg 2000; 106 (01) 25-35
    Google Scholar
  • 2 Zuker RM, Iconomou TG, Michelow B. Giant congenital pigmented nevi of the face: operative management and risk of malignancy. Can J Plast Surg 1995; 3: 39-44
    Google Scholar
  • 3 Argenta LC, Marks MW, Pasyk KA. Advances in tissue expansion. Clin Plast Surg 1985; 12 (02) 159-171
    Google Scholar
  • 4 Bauer BS, Vicari FA, Richard ME. The role of tissue expansion in pediatric plastic surgery. Clin Plast Surg 1990; 17 (01) 101-112
    Google Scholar
  • 5 Hudson DA, Lazarus D, Silfen R. The use of serial tissue expansion in pediatric plastic surgery. Ann Plast Surg 2000; 45 (06) 589-593 , discussion 593–594
    Google Scholar
  • 6 Oh SI, Lee YH. Multidirectional vector excision leads to better outcomes than traditional elliptical excision of facial congenital melanocytic nevus. Arch Plast Surg 2013; 40 (05) 570-574
    Google Scholar
  • 7 Hamilton SA, Kirk J, Morris AM. Long-term results of surgical excision and skin grafting for a giant hairy naevus of the face: time for a return to conventional wisdom?. Br J Plast Surg 2001; 54 (06) 543-545
    Google Scholar
  • 8 Golcman B, Friedhofer H, Anger M, Golcman R. Giant congenital composite melanocytic nevus on the face and scalp: treatment by multiple resections and grafting. J Dermatol Surg Oncol 1980; 6 (02) 130-132
    Google Scholar
  • 9 Mutti Lde A, Mascarenhas MRM, Paiva JMG de, Golcman R, Enokihara MY, Golcman B. Giant congenital melanocytic nevi: 40 years of experience with the serial excision technique. An Bras Dermatol 2017; (92) 256-259
    Google Scholar
  • 10 Mahabbat N, Alohaideb N, Aldaghri F, Alshomer F, Murad MA. Functional subunit reconstruction of giant facial congenital melanocytic nevi in children with the use of matriderm and skin graft: surgical experience and literature review. Eplasty 2018; 18: e30
    Google Scholar
  • 11 Bauer BS, Few JW, Chavez CD, Galiano RD. The role of tissue expansion in the management of large congenital pigmented nevi of the forehead in the pediatric patient. Plast Reconstr Surg 2001; 107 (03) 668-675
    Google Scholar
  • 12 LoGiudice J, Gosain AK. Pediatric tissue expansion: indications and complications. J Craniofac Surg 2003; 14 (06) 866-872
    Google Scholar
  • 13 Fahmy MAB, Mazy A. The feasibility of tissue expanders in reconstruction of giant congenital melanocytic nevi in children. Surg Innov 2010; 17 (03) 189-194
    Google Scholar
  • 14 Zaal LH, van der Horst CM. Results of the early use of tissue expansion for giant congenital melanocytic naevi on the scalp and face. J Plast Reconstr Aesthet Surg 2009; 62 (02) 216-220
    Google Scholar
  • 15 Bauer BS, Margulis A. The expanded transposition flap: shifting paradigms based on experience gained from two decades of pediatric tissue expansion. Plast Reconstr Surg 2004; 114 (01) 98-106
    Google Scholar
  • 16 Kim MJ, Lee DH, Park DH. Multifactorial analysis of the surgical outcomes of giant congenital melanocytic nevi: single versus serial tissue expansion. Arch Plast Surg 2020; 47 (06) 551-558
    Google Scholar
  • 17 Gonzalez Ruiz Y, López Gutiérrez JC. Multiple tissue expansion for giant congenital melanocytic nevus. Ann Plast Surg 2017; 79 (06) e37-e40
    Google Scholar
  • 18 Sharma MK, Kumar N, Babu VS, Tiwari VK. Use of preexpanded forehead and neck skin in case of giant facial hairy naevus: planning and technique. Indian J Plast Surg 2021; 54 (02) 221-224
    Google Scholar
  • 19 Sellers DS, Miller SH, Demuth RJ, Klabacha ME. Repeated skin expansion to resurface a massive thigh wound. Plast Reconstr Surg 1986; 77 (04) 654-659
    Google Scholar
  • 20 Perlyn C, Meara JG, Smith JD, Breuing KH, Bartlett R. Secondary reconstruction of a giant congenital lentiginous dermal nevus with serial, large-volume tissue expansion. Ann Plast Surg 1999; 43 (05) 546-550
    Google Scholar
  • 21 Lee MK, Park SO, Choi TH. Serial tissue expansion at the same site in pediatric patients: is the subsequent expansion faster?. Arch Plast Surg 2017; 44 (06) 523-529
    Google Scholar
  • 22 Son TT, Dung PTV, Thuy TTH, Kien VD, Liem NT. The role of rapid tissue expansion in separating xipho-omphalopagus conjoined twins in Vietnam. Arch Plast Surg 2021; 48 (04) 378-383
    Google Scholar