Application of a pre-expanded cross-legged tubed flap to reconstruct extensive GCMN of distal lower limb in children

• Published in: European journal of plastic surgery 2023-12, Vol.46 (6), p.1273-1281
• Main Authors: Yang, Jifan, Han, Bing, Fan, Jincai, Song, Jipeng, Zhang, Tiran, Pan, Qi, Tian, Jia
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Paper; Plastic Surgery
• ISSN: 1435-0130; 1435-0130
• DOI: 10.1007/s00238-023-02139-0

Background Reconstructing extensive giant congenital melanocytic nevus (GCMN) of children’s distal lower limbs remains a challenge for plastic surgeon. In this article, we introduced a pre-expanded cross-legged tubed flap for reconstruction of extensive GCMN in distal lower limbs of children. Methods Thirteen children were enrolled in our study. The whole surgical course was divided into four stages, including implantation of a tissue expander, formation of the tubed flap, cross-legged posture phase, and transfer of the flap. Postoperative follow-up and a questionnaire survey were conducted for determining multifaceted outcomes of the flaps. Results Eighteen pre-expanded cross-legged tubed flaps were harvested in the 13 children. Five of the 13 children received the treatment for two times. Mean size of these flaps was over 2% of total body surface area (TBSA) in our cases. The flaps were successfully transferred without serious complication. With the follow-up over 12 months, the flaps demonstrated satisfying outcomes functionally and esthetically. Nine of the 13 children’s legal guardians finished the questionnaire. Six children were found more positive in the social communication after the surgery. Conclusions Pre-expanded cross-legged tubed flap is an efficient, esthetically pleasing, and safe way for reconstruction of extensive GCMN in children’s distal lower limbs, which is meaningful for children’s social well-being. Level of evidence Level VI, Therapeutic