Reconstruction of Back Defect from Giant Congenital Melanocytic Nevus Using Dermal Substitute Matrix.

Area of Science:

• Plastic Surgery
• Dermatology
• Regenerative Medicine

Background:

• Giant congenital melanocytic nevi (GCMN) are congenital pigmented lesions with malignant transformation risk.
• Complete excision is necessary to mitigate cancer risk but often results in large, complex defects.
• Reconstruction of extensive GCMN defects presents significant surgical challenges.

Observation:

• A pediatric patient presented with a GCMN covering the entire back (18% total body surface area).
• The GCMN was surgically excised, creating a massive full-thickness defect.
• Integra (a dermal regeneration template) and meshed skin grafts were employed for reconstruction.

Findings:

• The largest defect in the literature from GCMN excision was successfully reconstructed using Integra and meshed skin grafts.
• Complete graft take was observed within 26 days post-excision.
• The patient achieved satisfactory functional outcomes following the reconstructive procedure.

Implications:

• This case demonstrates the efficacy of Integra and meshed skin grafting for extensive GCMN defects in pediatric patients.
• The technique offers a viable solution for managing large-scale reconstructions after GCMN removal.
• Successful reconstruction can significantly improve patient quality of life and reduce long-term morbidity.