Autologous cultured skin substitutes conserve donor autograft in elective treatment of congenital giant melanocytic nevus

This report presents a series of two patients having giant congenital nevi (400 to 650 cm ²) treated by excision and grafting with autologous cultured skin substitutes prepared from less than 20 cm ² of donor skin autograft. Nevi were excised to fascia and grafted with cadaveric allograft for 1 week, followed by removal of the allograft and grafting with cultured skin substitutes. The mean ratio of closed to donor areas was 26. In comparison to sheet split-thickness skin grafting, cultured skin substitutes exhibited comparable cosmesis, pliability, and durability while reducing the donor-site area by approximately one order of magnitude.