| Objective:The giant nevus is an benign skin tumor characterized by abnormal migration ofmelanoma cells gathering at the surface and with large distribution area. May involvethe entire limb, scalp, shoulders, trunk, etc. Giant nevus lead to rough skin,thickening,attached the hair,ulceration. Even associated with neurofibromatosis, somemay be malignant, such as secondarymelanoma.From the prospective follow-upresults,the rate of malignant transformation of giant nevus range by10%-20%, the giantnevus resectionspecimens positive detectionrate lower than the above values, relevantreports that melanoma patients is secondary to a giant nevus accounting for40%-60%.At the same time, the giant nevus is often in the exposed position and seriously affectsthe appearance. More negative impact to the community andthepatients’mentalhealth,soits treatment is imperative.Most scholars believe that there should be a pathological examination and earlysurgery when the giant nevus appear some symptoms of significantly increased, thecolor changed, ulceration, hair removal, the advent of satellite lesions, secondaryinfection and pain. Even without the above performance, we should also conductpreventive surgery. Current research is more focused on the improvement of the giantnevus surgery in order to promote the stability of the function and changeable of themorphology. At home and abroad there are many reports on the giant nevus. Such aslasers, chemicals, freezing, electrocautery, herbal smear and so on. The surgery is amore reliable method of treatment of giant nevus. Surgical methods such as cuttingmethod, the giant nevus removal skin graft method, expansion after expansion of theskin and soft tissue flap method, local flap, skin tube and the excision of the transfermethod. Postoperative wound defects, skin source of difficulties and scar after healingcomplications, often causing unbearable pain to the patients body.Epithelialization of the wound on wound healing is extremely important, theprocess of epithelialization of the wound, reflecting the degree of wound healing in thewound healing process, proper and early epithelialization not only protecting thewound, reducing the incidence of infection and other complications, but also havepositive significance to the prevention and treatment of complications of late scarcontracture or hyperplasiahas. Related studies have shown that epidermal stem cells has an important role in the wound epithelialization, epidermal stem cells has apositive meaning on wound healing.Previous relevant research and clinical treatment provides a good foundation forthe treatment of giant nevus. However, treatment often can not fully access to thepatient’s satisfaction, especially for larger special parts of the giant mole, due to lack ofstandardized treatment guidance mode, and thus can not make it functionalmorphology to achieve the desired results. In this paper, the epidermal stem-cell patchto repair wound defects of the giant mole cutting postoperative, clinical efficacy, toexplore one effective method which can not only save the skin source, but also betterimprove the functional morphology of the giant mole surgery.Methods: In this group we have4males and6females; ages of1year to3.5years, an average of2.5years, all congenital, the larger the age, the larger the giantmole area, the giant mole range of25cm×10cm~45cm×65cm.Ten patients were previously untreated, the torso, two thighs are the surgical site.Hospital for tests found that one of the cases’ giant mole surface skin ulcerated andexudated, three cases’ hair growth, The remaining six cases of skin texture isconsistent with the surroundings, two of them feel obviously itching.Pathologicalexamination confirmed four cases at the junction of mole, mixed mole ofsix cases, design surgical staging of the program according to the parts of thedistribution of patients with giant nevus. The experiment was consent by the patients’parents, Signed ethics agreement, then Venous blood and isolated and culturedepidermal stem cells in tissue engineering the National Engineering Center of HenanUniversity of Science and Technology Institute of Biotechnology. Stem cell culturethree weeks will the epidermal stem cell patch, then transplantation them in giantnevus cutting postoperative wound, external use oil more help dressing, with sterilegauze bandage to make it fixed, four-five days removal of the dressing. Control groupadmitted to hospital for surgery, cutting autologous skin graft transplantation, externaluse oil more help dressing, with sterile gauze bandage to make it fixed, four-five daysremoval of the dressing. Observe the time of wound healing and the situation after thehealing.Using SPSS16.0statistical software for analysis. The data were expressed bymean±standard eviation, and compared the two groups with t tests; inspection level α=0.05.Results:1. No significant complications such as infection when the two groupsof patients with giant nevus do the cutting surgery.2. Experimental group’ woundhealing time was significantly shorter than the control group.(P<0.05).3. Patients werefollowed up for7months to2years, an average of15months. Experimental groupperformance in the scar formation or contracture, skin color, elasticity and thefunctions of local organs pulling the skin better than the control group.Conclusions：Repair the secondary wound cutting the nevus with skin stemcells diaphragm, the postoperative complications slight.2Repair the secondary woundcutting the nevus with skin stem cells diaphragm, which can obviously reduce healingtime.3. Repair the secondary wound cutting the nevus with skin stem cells diaphragmwhich doesn’t need the skin area, or expand the resection of the nevus4.Repair thesecondary wound cutting the nevus with skin stem cells diaphragm, which was suitablefor junctional nevus, compound nevus, while not suitable for intradermal nevus.5.Repair the secondary wound cutting the nevus with thickness graft, which shows morecomplications6. Repair the secondary wound cutting the nevus with thickness graft, which was suitable for intradermal nevus, compound nevus, while not suitable for junctionalnevus. |
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