Giant naevus, giant excision, eleg(i)ant closure? Reconstructive surgery with Integra Artificial Skin^® to treat giant congenital melanocytic naevi in children☆

Summary 

Background

The optimal surgical treatment of giant congenital melanocytic naevi remains a considerable challenge in reconstructive surgery. None of the currently available techniques is universally applicable. The goal of this pilot study was to test Integra Artificial Skin^® (Integra) in the surgical treatment of giant congenital melanocytic naevi.

Methods

Between May 2000 and March 2004, Integra was used in 12 children (n=12; aged seven months to 11 years, mean 3.8 years). Giant congenital melanocytic naevi covered 1–12% of the total body surface area (mean 4.2%) located over the trunk in 50%, and over face and extremities in 25% each.

Results

In eight children, Integra implantation was primarily successful; in four patients a partial or complete removal and re-implantation was necessary due to complications. The final take rate of Integra ranged from 95–100%, except for one patient with a take rate of 30% (mean 93%). Second stage split-thickness skin grafting yielded take rates from 95–100% (mean 98%). Functional and cosmetic outcome was rated excellent in 58%, good in 25% and fair in 17% (follow-up six months to four years, mean 2.2 years).

Conclusions

These results suggest that Integra is a new and valid method to successfully treat giant congenital melanocytic naevi in early childhood in a definitive manner and with high-quality results.

Keywords: Giant congenital melanocytic naevi, Integra Artificial Skin, Dermal regeneration template, Reconstructive surgery, Children