[Frontal and scalp expanded skin flap combined with laser hair removal for children congenital facial giant nevi].

Objective:To investigate the feasibility and therapeutic effect of frontal and scalp expanded skin flap combined with laser hair removal for children congenital facial giant nevi. Methods:From January 2013 to December 2015,6 cases with congenital facial giant nevi were treated with expanded frontal and scalp skin flap combined with laser hair removal in the department of plastic surgery, An Zhen Hospital, Capital Medical University. The process of treatment could be divided into three stages. Stage 1:The expander capacity was determined according to the size of lesion. Expander was implanted under the galea aponeurotica in front and scalp, and expanded regularly postoperatively. Stage 2:The expander was removed and facial giant nevi was excised. The expanded skin flap was designed according to the shape and size of nevi. Stage 3:After the expanded skin flap healed completely, laser hair removal was performed for 4-6 times with 6 weeks of interval time. Results:300 ml to 350 ml expanders were selected with expanding frequency of 2 times a week. The expansion time lasted for 16 to 20 weeks(average,18.7 weeks).The complications such as leakage, angle and skin flap blood supply obstacle didnt occurr in the process of expansion. The size of frontal and scalp skin flap ranged from 12 cm × 11 cm to 20 cm × 17 cm. Venous drainage disorder happened in one flap and was treated by partial suture removal and acupuncturebleeding treatment. Skin flap necrosis didn't occurred. The defects at donor sites were sutured directly with inconspicious scar. The effect of semiconductor laser hair removal was good without recurrence during oneyear follow-up period. All expanded skin flaps had no obvious contraction with good match of color and texture. Conclusions:This method provides a new selection of donor site for larger facial defect with reliable effect. The facial giant nevi could be excised completely and repaired in one operation with short operation time. The scar in middle face and secondary deformities can be avoided.