Abstract
Abstract
Giant congenital melanocytic naevi (GCMN) presenting over large surface areas pose significant reconstructive challenges following surgical excision. We report the case of a paediatric female with a symptomatic GCMN covering ~2% of total body surface area on the right thigh, causing recurrent ulceration and psychological distress. Following failed conservative management, excision under general anaesthetic was performed, with reconstruction of the thigh defect using NovoSorb™ Biodegradable Temporizing Matrix (BTM). Despite a series of sequential infectious and contamination episodes during integration—including bacterial infection with Escherichia coli, Pseudomonas aeruginosa, and Klebsiella variicola, urine contamination, and maggot infestation—BTM maintained integration with conservative management. Successful split-thickness skin grafting was achieved at 4 weeks, with complete wound healing at 4 months and a well-matured scar at 1 year. This case supports BTM as a robust option for paediatric GCMN reconstruction in anatomically challenging, high-contamination locations.