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

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

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

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Funding

This research was supported by the National Natural Science Foundation of China (82103764).

Author information

Authors and Affiliations

  1. The Scar and Wound Treatment Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Road, Beijing, 100144, China

    Jifan Yang, Bing Han, Jincai Fan, Jipeng Song, Tiran Zhang, Qi Pan & Jia Tian

Authors
  1. Jifan Yang
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  2. Bing Han
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  3. Jincai Fan
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  4. Jipeng Song
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  5. Tiran Zhang
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  6. Qi Pan
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  7. Jia Tian
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Contributions

JT designed the flap and performed the operations as the chief surgeon. JF and JT edited the manuscript. QP and JF made the surgical diagram. BH and JS investigated the clinical information and interpreted these data. JF, TZ, and BH revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jia Tian.

Ethics declarations

Ethics approval

All procedures were in accordance with the 1964 Helsinski Declaration and its later amendments. The research protocol was approved by the Institutional Review Board of The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS).

Consent to participate

Informed consent was obtained from the parents or legal guardians of all individual participants included in the study.

Consent for publication

The authors affirm that parents or legal guardians of individual participants provided informed consent for publication of the images in Figs. 2, 3, and 4.

Conflict of interest

Jifan Yang, Bing Han, Jincai Fan, Jipeng Song, Tiran Zhang, Qi Pan and Jia Tian declare no competing interests.

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Yang, J., Han, B., Fan, J. et al. Application of a pre-expanded cross-legged tubed flap to reconstruct extensive GCMN of distal lower limb in children. Eur J Plast Surg 46, 1273–1281 (2023). https://doi.org/10.1007/s00238-023-02139-0

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  • DOI: https://doi.org/10.1007/s00238-023-02139-0

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