Radical Resection of Giant Congenital Melanocytic Nevus and Reconstruction With Meek-Graft Covered Integra Dermal Template

Kopp, Jürgen; Noah, Ernst Magnus; Rübben, Albert; Pallua, Norbert

doi:10.1046/j.1524-4725.2003.29157.x

Cited by 18 publications

(6 citation statements)

References 32 publications

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“…The modified Meek technique in combination with Integra TM dermal template in a two-stage procedure has been reported in extensive burns with some success in a case report involving three patients [ 112 ]. As well, radical resection and reconstruction of a giant congenital melanocytic nevus with meek-graft covered Integra was also reported [ 113 ]. However, there are very few reports that utilised the above described technique subsequently.…”

Section: Reviewmentioning

confidence: 99%

Skin tissue engineering advances in severe burns: review and therapeutic applications

et al. 2016

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Current advances in basic stem cell research and tissue engineering augur well for the development of improved cultured skin tissue substitutes: a class of products that is still fraught with limitations for clinical use. Although the ability to grow autologous keratinocytes in-vitro from a small skin biopsy into sheets of stratified epithelium (within 3 to 4 weeks) helped alleviate the problem of insufficient donor site for extensive burn, many burn units still have to grapple with insufficient skin allografts which are used as intermediate wound coverage after burn excision. Alternatives offered by tissue-engineered skin dermal replacements to meet emergency demand have been used fairly successfully. Despite the availability of these commercial products, they all suffer from the same problems of extremely high cost, sub-normal skin microstructure and inconsistent engraftment, especially in full thickness burns. Clinical practice for severe burn treatment has since evolved to incorporate these tissue-engineered skin substitutes, usually as an adjunct to speed up epithelization for wound closure and/or to improve quality of life by improving the functional and cosmetic results long-term. This review seeks to bring the reader through the beginnings of skin tissue engineering, the utilization of some of the key products developed for the treatment of severe burns and the hope of harnessing stem cells to improve on current practice.

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Section: Reviewmentioning

confidence: 99%

Skin tissue engineering advances in severe burns: review and therapeutic applications

et al. 2016

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“…13 However, many of these techniques involve multiple procedures with a poor final cosmetic result, particularly for giant CMN. The use of CO 2 laser is particularly attractive because it offers the possibility of precise vaporization of the superficial part of the CMN down to the upper dermis thereby removing the visible pigment without residual scarring.…”

mentioning

confidence: 99%

Treatment of Congenital Melanocytic Naevi With CO2 Laser

Horner¹,

El-Muttardi²,

Mayou³

2005

Annals of Plastic Surgery

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This study assesses the effectiveness of CO2 laser in treating congenital melanocytic naevi (CMN). A retrospective review of 12 patients with CMN treated with CO2 laser was carried out. In all cases, there was minimal visible naevus after treatment. Six patients developed hypertrophic scarring; this was significantly more likely following CO2 laser treatment on the anterior torso, flanks, or arms than on the back or buttocks (P = 0.01, 1-tailed Fisher exact test). We conclude that CO2 laser is an effective treatment for reducing visible pigmentation of CMN. However, it can cause hypertrophic scarring, which has not been reported before. This risk can be reduced by limited use in areas of the body where the dermis is thinner or there is a known risk of hypertrophic scarring. In addition, the cautious use of paint mode and prophylactic use of pressure or silicon dressings may also reduce the risk of hypertrophic scarring.

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“…The data extracted in the review is best estimated from large prospective studies; however, these data are rare. The first reported case of Integra for this purpose was in 2003 by Kopp et al [11, 12]. Since then, there have been a few reported cases in the English literature.…”

Section: Discussionmentioning

confidence: 99%

Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases

Opoku-Agyeman

Humenansky

Davis

et al. 2019

Surgery Research and Practice

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Background The use of Integra Dermal Reconstruction Template has emerged as an option for wound reconstruction, after resection of congenital nevi, especially giant congenital nevi. There have been many reports on Integra use in the literature for this purpose. This systematic review with pooled analysis examines the current literature regarding Integra use after resection of congenital nevi, including patient characteristics and reported outcomes. Methods Systematic electronic searches were performed using PubMed, Ovid, Embase, and Cochrane library databases for studies reporting the use of Integra to reconstruct defects after nevi resection. Studies were analyzed if they met the inclusion criteria. Pooled descriptive statistics were performed. Results Thirteen studies that met the inclusion criteria were included for analysis, yielding 31 procedures in 31 patients. Eleven of the thirteen studies were case reports representing 17 of the 31 patients. One study was retrospective, and the other study was a prospective study. The mean follow-up was 2.67 years (range, 0.2–13 years). The overall wound closure rate was 100%. The overall initial Integra take rate was 90.3% and the skin graft take rate was 100%. The rate of reported complications was 14.8%. The average age of patients was 7.36 years. The average size of the nevus was 6.29% TBSA (range, 0.005%–26%), and the time to definitive skin grafting was 3.28 weeks. Significant heterogeneity was found among the published studies. Conclusion We conclude that the use of Integra appears to be a safe and viable option for defect reconstruction after the primary or secondary excision of congenital nevi of different sizes and on most parts of the body. Long-term follow-up studies and prospective cohort studies are required in order to fully estimate the incidence of complications. However, the rarity of this condition make these types of studies very difficult.

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Radical Resection of Giant Congenital Melanocytic Nevus and Reconstruction With Meek-Graft Covered Integra Dermal Template

Abstract: The introduced practice demonstrates a useful alternative to established methods, particularly if tumor excision in large areas and subsequent wound closure might be achieved in one procedure.

Cited by 18 publications

References 32 publications

Skin tissue engineering advances in severe burns: review and therapeutic applications

Skin tissue engineering advances in severe burns: review and therapeutic applications

Treatment of Congenital Melanocytic Naevi With CO2 Laser

Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases

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