Application of mesh acellular allogeneic dermal matrix and split thickness autogenous skin to treat giant congenital melanocytic nevi in children

Abstract

Objective To explore the methods and the long-term outcome of composite skin graft with mesh acellular allogeneic dermal matrix(allo-ADM)and split thickness autogenous skin giant congenital melanocytic nevi in infants. Methods From January 2012 to February 2017 our department applied acellular allogeneic dermis matrix(allo-ADM)with split thickness autogenous skin to treat 55 Giant congenital melanocytic nevi in infants and children aged 3 months to 5 years and 10 months, an average age was 1 years and 2 months, the area of 1%-25% TBSA. There were 12 cases of head and face, 28 cases of trunk and 15 cases of limbs. In operation, giant congenital melanocytic nevi was totally or partially resected, and using allo-ADM and split thickness autogenous skin graft to cover the wounds. Pressured gauze was removed 2 weeks after surgery, and at the same time the cicatricial rehabilitation was performed. The follow-up point was at 3 months, 6 months, 1 year, 2 years, to observe composite skin′ color, softness, and pathological examination of giant nevus and composite skin after 1 years were performed. Results 2 weeks after transplantation the composite skin survival rate in 70%-100%; 38 cases were followed up for more than 2 years. For patients, over 1 years postoperatively, the composite skin presented soft and flexible, and the color were closed to the normal skin. Conclusions Acellular allogeneic dermis matrix with split-thickness autogenous skin to composite transplantation can effectively improve the appearance and function of giant congenital melanocytic nevi in infants and children, and avoid the scar formation due to the adoption of full thickness skin. The key is to ensure the early survival rate of composite skin graft. Key words: Melanocytic nevi; Cellular allogeneic dermal matrix; Infants