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Innovations in Treatment
Case report
Simplified management of a giant forehead congenital nevus allows for early reconstruction
  1. Moris Topaz1,
  2. Michael Gurevich2 and
  3. Itamar Ashkenazi3
  1. 1Hillel Yaffe Medical Center, Hadera, Israel
  2. 2Transplant Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
  3. 3Surgery Department, Rambam Health Care Campus, Haifa, Haifa, Israel
  1. Correspondence to Dr Moris Topaz; mtopazmd{at}yahoo.com

Abstract

We report simplified surgical management of giant congenital forehead nevus that customarily requires the use of tissue expander for complete excision. Commencing treatment at the age of 3 months, the TopClosure tension relief system (TRS) was applied as an external tissue expander allowing preoperative skin stretching by mechanical creep. This was followed by partial excision of the nevus. Intraoperative stress-relaxation allowed further expansion of the skin. Postoperative wound closure was secured with the aid of the TRS. Repeated, six simple staged excisions of the forehead lesion and a minor skin graft to the eyelid part, allowed for delayed primary closure of the entire lesion by the age of 2. This simple alternative approach, which allows the early start and early conclusion of the reconstructive process, should be considered as the primary option in the treatment of these patients.

  • congenital disorders
  • dermatology
  • plastic and reconstructive surgery
  • skin
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bcr-2019-234164

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    Footnotes

    • Contributors MT contributed substantially to the conception and/or design of the work, and acquisition and interpretation of data. MT and IA drafted the work. MT, MG and IA revised it critically for important intellectual content. MT, MG and IA gave final approval of the version published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests MT is one of the developers of the TopClosure Tension-Relief System. He is also the chairman of IVT Medical Ltd., manufacturers of the TopClosure Tension-Relief System.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.