Clinical Observation Of Surgical Treatment For Melanocytic Nevi On Children In 229 Cases

Objective Retrospective analysis was made upon clinical data of 229 children with melanocytic nevi to summarize the treatment experience.Methods Medical records of treatment of 229 children with melanocytic nevi were statistically analyzed and the effect of treatment was followed up after surgery. All 229 subjects aged from 42 days to 15 years old, among which males and females had 105 and 124 cases respectively. Lesion location included head and face(131 cases), neck (11 cases), upper limb (21 cases), lower limb (45 cases), trunk (15 cases), buttocks and perineal region (6 cases).132 cases have been underwent one-stage resection and decompression; 36 patients underwent fractional resection;besides there were 59 cases had removed the lesion with excision, skin grafting or local flap grafting, of which 3 ware used expanded flap to cover the wound,20 were used local flap grafts,2 were used both artificial dermis and autologous skin to repair the wound. Curative effect can be divided into four levels:optimal, scar to the naked eye is not easy to see, skin color and adjacent normal skin color area is consistent; good, visible linear scarring, skin color close to the adjacent normal area; general, obvious visible in the formation of scar, but better than pre-operation; poor, scar obvious and local deformation. Through this we can make the evaluation of postoperative therapeutic effect.Results All the patients were cured. A total of 189 cases of patients were followed up, good effect for optimal with 146 cases, good effect for 20 cases, the effect is general in 18 cases, the effect is poor in 5 cases.These cases were followed up for 1 month to six months. All the patients were cured and discharged in one stage healing. Hyperplastic scar and scar contracture didn’t happen after operation. The found appeared almost normal color and good elasticity, and got desirable effect.1 case have got serious hyperplastic scar after dermabrasion plus blade thickness skin graft to cover the wound, and the others have got slight or medium hyperplastic scar. And the Skin graft area covered with the full thickness graft or the mid-thick skin, it’scut edge have got slight hyperplastic scar.Conclusion l.The melanocytic nevi in children always be found in head and face, especially in females, and 99.1% is found in infancy.2.The single completer resection is always the first choice for us to treat melanocytic nevi, and the serial partial excision or skin-grafting take the second place.For the cases which are hard to suture directly, we can remove the lesion first, then use the adjacent flap or expanded flap to cover the woundand in this way the children can have more beautiful appearance.Skin-grafting is beneficial to cover the wound which have large areas, while the changes of skin color and hyperplastic scar after operation are the complication of skin-grafting.3.It’s a new way to use the artificial dermis to cover the wound in the one-stageoperation combining with the autologous skin to cover the wound in the second-stage operation to treat the giant nevus.However the long cycle of therapy and hyperplastic scar developing in the early stage are the problem, the long-term effect should be followed up.