title: Early excision of congenital melanocytic nevi under tumescent anesthesia and skin expansion by intracutaneous double butterfly sutures.
abstract: BACKGROUND
  Excision of large congenital melanocytic nevi is recommended because of the risk of malignant transformation and for aesthetic reasons. Our treatment concept includes 1) excision in one or more steps preferably before the age of one year, 2) skin expansion through high-tension wound closure with intracutaneous double butterfly sutures and 3) performing surgery with tumescent or general anesthesia.
  
  
  METHODS
  A retrospective survey was conducted among all parents with children treated for congenital melanocytic nevi in 2004 or 2005 with a maximum age of 6.0 years. The parents were asked to evaluate the trauma associated with their child's surgery and the aesthetic result.
  
  
  RESULTS
  Fifty-nine families were contacted, of whom 51 replied. Forty-two parents assessed surgery-associated trauma as light or very light. Thirty-nine parents rated the aesthetic results as good to very good. Severe complications did not occur.
  
  
  CONCLUSIONS
  The proposed surgical concept is a safe procedure with good aesthetic results and low surgery-associated trauma for the child.
authors.affiliation: Department of Dermatology, University of Tübingen, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Rothfuss
authors.forename: Melany
authors.initials: M
authors.lastname: Schilling
authors.forename: Helmut
authors.initials: H
authors.lastname: Breuninger
mesh_terms: D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D007223:Infant; D009508:Nevus, Pigmented / Q000151:congenital* / Q000601:surgery*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000151:congenital* / Q000601:surgery*; D013536:Suture Techniques; D015626:Tissue Expansion / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000779:Anesthetics, Local