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CC BY-NC 4.0 · Arch Plast Surg 2020; 47(06): 551-558
DOI: 10.5999/aps.2020.01494
Original Article

Multifactorial analysis of the surgical outcomes of giant congenital melanocytic nevi: Single versus serial tissue expansion

Min Ji Kim 
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
,
Dong Hwan Lee 
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
,
Dong Ha Park 
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
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Background Giant congenital melanocytic nevus (GCMN) is a rare disease, for which complete surgical resection is recommended. However, the size of the lesions presents problems for the management of the condition. The most popular approach is to use a tissue expander; however, single-stage expansion in reconstructive surgery for GCMN cannot always address the entire defect. Few reports have compared tissue expansion techniques. The present study compared single and serial expansion to analyze the risk factors for complications and the surgical outcomes of the two techniques.

Methods We retrospectively reviewed the medical charts of patients who underwent tissue expander reconstruction between March 2011 and July 2019. Serial expansion was indicated in cases of anatomically obvious defects after the first expansion, limited skin expansion with two more expander insertions, or capsular contracture after removal of the first expander.

Results Fifty-five patients (88 cases) were analyzed, of whom 31 underwent serial expansion. The number of expanders inserted was higher in the serial-expansion group (P<0.001). The back and lower extremities were the most common locations for single and serial expansion, respectively (P=0.043). Multivariate analysis showed that sex (odds ratio [OR], 0.257; P=0.015), expander size (OR, 1.016; P=0.015), and inflation volume (OR, 0.987; P=0.015) were risk factors for complications.

Conclusions Serial expansion is a good option for GCMN management. We demonstrated that large-sized expanders and large inflation volumes can lead to complications, and therefore require risk-reducing strategies. Nonetheless, serial expansion with proper management is appropriate for certain patients and can provide aesthetically satisfactory outcomes.

Keywords

Nevus, pigmented - Skin neoplasms - Tissue expansion - Tissue expansion devices - Surgical flaps


Publication History

Received: 22 July 2020

Accepted: 03 November 2020

Article published online:
25 March 2022

© 2020. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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