Current Surgical Management of Giant Congenital Melanocytic Nevi of the Upper Extremity

Congenital Melanocytic Nevi (CMN) is advised excised because of the possibility of it degenerating into a malignant or for aesthetic concerns. With the progress of the times and the development of science and technology, treating giant congenital melanocytic nevi of the upper extremity requires comprehensive measures. A 22-old-girl with giant congenital melanocytic nevi from the left shoulder joint to the elbow joint in our hospital, we make a clinical route for her treatment. There were 5 stages to the surgical procedure. First stage, the endoscopic placement of tissue expander was inserted into the subcutaneous pocket; second stage, partial excision of the nevus and direct closure of the defect. Third stage, the expander was removed, lesions or scars were excised, and the wound of the upper extremity was placed into the pocket to delay healing, Hyperbaric Oxygen (HBO2) therapy was initiated for post-reconstructive flap; forth stage, the residual lesion was excised and the pedicle was removed, the pedicle flap was then unfolded to resurface the wound, HBO2 therapy was initiated as the second stage; fifth stage, hypertrophic scar of the upper extremity was treated with ultra pulse CO2 fractional laser. Optimal aesthetic and functional result was obtained in the right upper extremity.