title: Hydrosurgery, a new therapeutic perspective in early care of giant congenital nevi: a preliminary series of four cases.
abstract: BACKGROUND
  Congenital melanocytic nevi are present at birth or may appear in the first weeks of life. Small and medium-size lesions are relatively common, affecting approximately 1% of newborns; large or giant melanocytic nevi occur in 1/20,000-1/500,000 births. The main concern raised by these lesions is their potential risk of degeneration which is strongly size-dependent and estimated in the literature between 0% and 40% over a lifetime. Although multiple treatment modalities have been described, to date there is no consensus regarding their optimal management.
  
  
  METHODS
  Four neonates (three females and one male) presenting giant congenital nevi with a mean age 12 days (7-24 days) were referred to our Plastic Surgery department for treatment from 2012 to 2013. All patients underwent an alternative dermabrasion procedure with the innovative use of hydrosurgery. All procedures were performed under general anaesthesia by the same senior operator (Dr. B.Bayet).
  
  
  RESULTS
  The mean operating time was significantly reduced compared to conventional techniques. No complications were observed in the postoperative course. Good final results were obtained in three patients after a mean follow-up of respectively 11, 8 and 4 months. The first operated neonate showed a complete recurrence of pigmentation of the treated areas after 6 months.
  
  
  CONCLUSIONS
  The need for early treatment in giant congenital nevi is admitted by all. Hydrosurgery is easy to use and allows to achieve a selective and symmetric resection with an obvious cleavage plane and clean-cut borders. Furthermore, this procedure has convinced us with its speed of use, ensuring significant time saving, and therefore less morbidity for the neonate. Aesthetic results as well as recurrence rate may be comparable to conventional techniques. However, regular follow-up to detect any malignancy is necessary.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Saint-Luc Academic Hospital, Catholic University of Louvain, Avenue Hippocrate 10, B-1200 Brussels, Belgium.
authors.forename: Maude
authors.initials: M
authors.lastname: Coyette
authors.affiliation: Department of Plastic and Reconstructive Surgery, Saint-Luc Academic Hospital, Catholic University of Louvain, Avenue Hippocrate 10, B-1200 Brussels, Belgium.
authors.forename: Anass
authors.initials: A
authors.lastname: Elajmi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Saint-Luc Academic Hospital, Catholic University of Louvain, Avenue Hippocrate 10, B-1200 Brussels, Belgium.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Bayet
authors.affiliation: Department of Plastic and Reconstructive Surgery, Saint-Luc Academic Hospital, Catholic University of Louvain, Avenue Hippocrate 10, B-1200 Brussels, Belgium. Electronic address: benoit.lengele@uclouvain.be.
authors.forename: Benoît
authors.initials: B
authors.lastname: Lengelé
mesh_terms: D003646:Debridement / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009508:Nevus, Pigmented / Q000151:congenital / Q000601:surgery*; D061646:Operative Time; D012878:Skin Neoplasms / Q000151:congenital / Q000601:surgery*; D012965:Sodium Chloride
chemical_list: D012965:Sodium Chloride
keywords: Congenital melanocytic nevi; Hydrosurgery; Morbidity; Risk of degeneration; Treatment