Treatment of giant congenital nevi with autologous cultured epithelium with or without cryopreserved allogeneic skin

Nineteen operations were performed on 8 pediatric patients with giant congenital nevi. The lesions were tangentially excised using a hand-held knife, preserving as much adipose tissue as possible. Excised wounds were covered with cultured autografts (CAG) in 13 of the operations, and cultured autografts with cryopreserved allogeneic skin in the other 6 operations. In the first group, 13 CAG applications were performed in 7 patients. The average size of the CAG was 582cm² (range, 180 to 900cm². The grafts took well in 9 of the applications, especially in wounds of the extremities. One year later the grafted sites became soft and their appearance was acceptable. The grafts did not take well in 4 of the applications. In these cases the graft sites were located on the abdomen and buttocks. Later, the wounds were covered by conventional skin grafting. In the later group, 6 CAG applications were performed in 5 patients. The lesions on the chest, abdomen, and buttocks were deeply excised to the adipose tissue. The wound was covered with cryopreserved allograft skin. Later, the skin surface was abraded, and CAG were applied. The average size of CAG was 640cm² (range, 300-1,020cm²). The grafts took well on the allogeneic dermis in 5 of the applications and the wounds healed well. In 1 application, the wound was later covered by conventional skin grafting. Deeply excised wounds were well treated with cryopreserved allogeneic skin and CAG. However, scar contracture was observed when the wounds were located in the abdomen, buttocks and joint areas.