{"paper_id":"4cfc4ca5-f5fa-4f69-8fd3-0e8b8078fa3e","body_text":"Acellular dermal matrix improves clinical prognosis and skin healing after dermabrasion for congenital melanocytic nevus | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Acellular dermal matrix improves clinical prognosis and skin healing after dermabrasion for congenital melanocytic nevus Chenfei Li, Chunhuan Zhang, Zeliang He, Ran Jing, Sihao Nie, Botian Jiang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8900811/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background Congenital melanocytic nevus (CMN) is associated with aesthetic concerns and potential malignant transformation risks, with dermabrasion being a common therapeutic option. Postoperative wound healing remains a key challenge, and the value of acellular dermal matrix (ADM) in optimizing this process needs verification. Methods We retrospectively included a series of patients with CMN who underwent dermabrasion at our hospital from March 2016 to June 2024. Patients were divided into Group A (ADM wound coverage) and Group B (no ADM application). Basic patient information, lesion-related characteristics, perioperative indicators, wound re-epithelialization time, and Vancouver Scar Scale (VSS) scores were collected. Multiple linear regression analysis was performed to quantify the independent effect of ADM application on outcomes. Results A total of 59 patients were included (Group A: 32 cases; Group B: 27 cases). There were no significant differences between the two groups in age, gender, lesion size, lesion diameter, lesion location, presence of satellite lesions or presence of hair on the lesion ( P >0.05). No significant differences were observed in anesthesia method ( P = 0.416), operation time ( P = 0.429), intraoperative blood loss ( P = 0.554), or CHEOPS scores ( P = 0.075). Group A had shorter re-epithelialization time ( P = 0.027) and lower VSS scores ( P = 0.003) than Group B. Multiple linear regression confirmed ADM application as an independent protective factor for shorter re-epithelialization time (β=-1.703, 95% CI: -2.415~-0.991, P < 0.001) and lower VSS scores (β=-1.187, 95% CI: -1.605~-0.769, P < 0.001). No malignant transformation was noted during long-term follow-up. Conclusions ADM application after CMN dermabrasion significantly shortens wound healing time and improves scar quality, providing a valuable clinical option for CMN treatment. Congenital melanocytic nevus acellular dermal matrix dermabrasion Figures Figure 1 Introduction The congenital melanocytic nevus (CMN), a common congenital cutaneous lesion, arises from abnormal migration and aggregation of melanocytes during embryonic development, which can involve multiple body parts with significant variations in lesion size and depth[ 1 ]. Among them, large and giant CMN (with large surface areas) not only impose heavy psychological and social burdens on patients due to appearance abnormalities but also pose threats to patients' life and health due to potential malignant transformation risks, highlighting an urgent clinical need for safe and effective therapeutic interventions[ 2 ]. Dermabrasion, a commonly used technique in dermatologic surgery, has matured over years of development[ 3 ]. Its core principle is to remove lesional tissue through mechanical grinding, and it is particularly suitable for large/giant CMN that cannot be completely resected in a single operation[ 4 ]. This technique features relatively simple operation, controllable damage to normal tissues, maximum preservation of skin integrity, without the need for skin grafting, thus avoiding damage to the donor site[ 5 ]. However, the quality of wound healing after dermabrasion directly affects the overall therapeutic effect, which remains a key issue requiring further optimization in clinical practice. Acellular dermal matrix (ADM) is a biomaterial that retains the natural dermal matrix structure after special treatment to remove cellular components[ 6 ]. With the development of tissue engineering technology, it has been widely used in various clinical fields. The main matrix components of ADM include collagen, elastic fibers, and glycosaminoglycans, which possess good biocompatibility, biodegradability, and tissue repair activity[ 7 ]. It can provide a stable microenvironment for wound healing, promote the proliferation and migration of epithelial cells, and induce granulation tissue growth[ 8 ]. In the clinical intervention of various diseases such as burn wound repair, chronic refractory wound treatment, and plastic and aesthetic tissue filling, ADM has shown significant effects in promoting wound healing and reducing scar formation[ 9 , 10 ]. Although ADM has long been applied in clinical practice, no previous studies have explored its application in dermabrasion for CMN, which leaves a research gap in optimizing wound repair outcomes after this specific surgical procedure. Therefore, this study aimed to explore the application effect of ADM in wound repair after dermabrasion for CMN by comparing the postoperative clinical outcomes of patients with and without ADM application, so as to provide clinical references for optimizing the dermabrasion regimen for large/giant CMN and improving patient prognosis. Materials and methods 2.1 Study design and patient population We retrospectively reviewed patients with CMN who underwent dermabrasion treatment at the 980th Hospital of the Joint Logistic Support Force of the PLA from March 2016 to June 2024. Inclusion criteria were CMN confirmed by clinical examination and pathological biopsy and undergoing dermabrasion treatment. Exclusion criteria were other benign or malignant skin tumors, infectious skin diseases, autoimmune diseases, local skin trauma history, and incomplete clinical data. Patients were divided into two groups (Groups A and B) based on whether ADM was applied for postoperative wound bed coverage: Group A was treated with ADM for wound bed coverage, while Group B received no ADM application. Data were collected and analyzed using anonymous methods in all cases, and the waiver of informed consent for this study was approved by the Ethics Committee of the 980th Hospital of the Joint Logistic Support Force of the PLA. 2.2 Treatment and follow-up For older children with CMN less than 20 cm in diameter, local infiltration anesthesia with 0.5% lidocaine with epinephrine solution (1:200,000) is administered, while general anesthesia is used for all other children. Intraoperatively, a motor-driven dermabrasion instrument produced by NSK Ltd. (Tokyo, Japan) is employed, featuring a pedal-controlled speed typically set at 20,000 rpm and spindle-shaped metal burrs made of stainless steel. During the procedure, the assistant stretches the skin of the surgical field tightly, and physiological saline is sprayed via a syringe for cooling to avoid thermal tissue damage caused by the heat generated by the rotating burrs. The depth of dermabrasion must be strictly controlled within the epidermal-dermal junction. For areas with thin skin such as the face and neck, low speeds and minimal pressure are crucial. After dermabrasion, the wound surface is compressed with saline-soaked gauze containing epinephrine (1:100,000) for 5–10 minutes. Once no obvious active bleeding is observed, the wound is covered with sterile petrolatum gauze or ADM (Jiangsu Unitrump Biomedical Technology Co., Ltd., Nantong, China), followed by appropriate pressure bandaging with 6–8 layers of sterile gauze and cotton pads. Postoperatively, oral azithromycin 0.25g twice a day for 3 consecutive days is routinely prescribed for infection prophylaxis. Dressings are changed daily for 10–14 days until complete re-epithelialization of the wound is achieved. The follow-up duration is no less than 1 year, during which comprehensive physical examinations and special skin evaluations are conducted to screen for malignant lesions in the nevus itself and its surrounding areas (Fig. 1 ). 2.3 Data collection Basic patient information, including age and gender, was extracted from electronic medical records. At the first visit, the maximum lesion diameter and lesion area of CMN were measured. The lesion area was expressed as the percentage of total body surface area (TBSA). Additionally, the presence or absence of satellite lesions and hair on the lesion were recorded. Perioperative indicators were obtained from surgical records, including anesthesia method, operation time, and intraoperative blood loss. Postoperative pain was evaluated using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) on the 3rd postoperative day during dressing changes. The time required for complete wound re-epithelialization was recorded based on daily dressing change records. When the surface of the wound is completely covered by new epithelium, the dressing no longer adheres to the wound, and there are no obvious signs of exudation, redness, swelling or other manifestations of infection or poor healing, all dressings can be removed at this time, and it can be determined as complete re-epithelialization. At the last follow-up, the Vancouver Scar Scale (VSS) was used to assess scar quality, which included evaluations of scar vascularity, pigmentation, height, and flexibility. 2.4 Statistical analysis All statistical analyses were performed using Statistical Package for Social Sciences 26.0 (IBM Corporation, Armonk, New York, USA). Continuous variables were expressed as mean ±standard deviation, whereas categorical variables were presented in frequencies and percentages. The independent sample t -test or Mann-Whitney U test was used for numerical data, and the chi-square test was used to identify differences in frequency of categorical variables between groups. A multiple linear regression analysis was conducted to quantify the independent effect of group on the combined dependent variables. Variables with a P -value < 0.05 were included in the regression model. Results A total of 59 patients (average age at first visit: 6.3±2.0 years; 22 males [37.3%] and 37 females [62.7%]) who received dermabrasion treatment for CMN at The 980th Hospital of the Joint Logistic Support Force of the PLA were included in this study. Patients were divided into Group A and Group B based on whether ADM was used for postoperative wound bed coverage: Group A consisted of 32 cases with ADM applied for wound bed coverage, while Group B included 27 cases without ADM application. Comparison of baseline characteristics between the two groups revealed no statistically significant differences in age ( P = 0.672), gender ( P = 0.564), lesion size ( P = 0.640), lesion diameter ( P = 0.454), lesion location ( P = 0.862), presence of satellite lesions ( P = 0.117), or presence of hair on the lesion ( P = 0.778). These results indicate that the two groups had comparable baseline conditions (Table 1). Table 1 Baseline characteristics of patients with Congenital melanocytic nevus. Group A Group B P value No. of patients 32 27 Age (years) 6.17±1.98 6.39±2.10 0.672 Gender (male/female) 13/19 9/18 0.564 Size (% TBSA) 4.74±1.35 4.91±1.38 0.640 Lesion diameter (cm) 24.21±5.34 25.31±5.92 0.454 Location of lesion (Head and neck/Trunk/Extremities) 6/16/10 4/13/10 0.862 Satellites (yes/no) 7/25 11/16 0.117 Hair on lesion (yes/no) 13/19 10/17 0.778 Abbreviations: TBSA, Total body surface area. Among all patients, 2 cases developed postoperative fever (1 case in Group A and 1 case in Group B) without obvious infectious signs, and 1 case of wound infection occurred in Group B. All complications were resolved within one week after targeted management, with no impact on the overall treatment outcome. One patient in Group A developed local tiny nodules 8 months postoperatively. Pathological biopsy confirmed benign proliferative nodules, and no additional intervention was needed. No malignant transformation was noted during long-term follow-up. In terms of perioperative indicators, there were no statistically significant differences between the two groups in anesthesia methods ( P = 0.416), operation time ( P = 0.429), and intraoperative blood loss ( P = 0.554). The CHEOPS score evaluated on the 3rd postoperative day during dressing change also showed no significant difference between the two groups ( P = 0.075). Notably, there were significant statistical differences in wound re-epithelialization time and Vancouver Scar Scale (VSS) score between the two groups: the wound re-epithelialization time of Group A was significantly shorter than that of Group B ( P = 0.027), and the VSS score of Group A at the last follow-up was significantly lower than that of Group B ( P = 0.003) (Table 2). Table 2 Perioperative indicators and postoperative outcomes between the two groups. Group A Group B P value Anesthesia methods (local infiltration anesthesia / general anesthesia) 6/26 3/24 0.416 Operating time (min) 51.46±13.57 48.70±12.88 0.429 Intraoperative blood loss (ml) 18.20±4.27 18.88±4.51 0.554 CHEOPS 4.59±0.62 4.96±0.94 0.075 Re-epithelization time (day) 11.58±0.84 12.14±1.07 0.027 VSS 3.06±0.88 3.93±1.24 0.003 Abbreviations: CHEOPS, Children's Hospital of Eastern Ontario Pain Scale; VSS, Vancouver Scar Scale. To further quantify the independent effect of ADM application on clinical outcomes, a multiple linear regression analysis was conducted, with group as the sole independent variable and re-epithelialization time/VSS score as dependent variables. The model was statistically significant (F = 9.637, P < 0.001). ADM application was an independent protective factor, significantly reducing re-epithelialization time (β = -1.703, 95% CI: -2.415 to -0.991, P < 0.001) and VSS score (β = -1.187, 95% CI: -1.605 to -0.769, P < 0.001) (Table 3). These findings confirm that covering the wound with ADM can effectively promote the process of wound epithelialization, shorten the healing time, and significantly improve the scar quality after dermabrasion. Table 3 Results of multiple regression linear analysis. β 95% CI for β P value Re-epithelization time -1.703 -2.415~-0.991 <0.001 VSS -1.187 -1.605~-0.769 <0.001 Abbreviations: VSS, Vancouver Scar Scale; β, partial regression coefficient. Discussion In this study, we retrospectively analyzed CMN patients who underwent dermabrasion, comparing clinical outcomes between those with ADM wound coverage and those without. The results showed that ADM application significantly shortened wound re-epithelialization time and improved scar quality as evaluated by the VSS, providing important clinical evidence for enhancing CMN dermabrasion efficacy. CMN is a benign congenital cutaneous lesion derived from abnormal migration and aggregation of neural crest-derived melanocytes during embryonic development[11]. It exhibits substantial heterogeneity in size, morphology, and anatomical distribution, with clinical classification typically based on lesion size: small (<1.5 cm), medium (1.5-20 cm), large (20-40 cm), and giant (>40 cm)[12]. Large and giant CMN are clinically prominent due to their elevated lifetime risk of malignant transformation into melanoma and potential association with extracutaneous complications such as neurocutaneous melanosis[13]. From a molecular perspective, CMN pathogenesis is linked to postzygotic somatic mutations, with NRAS codon 61 mutations being the most prevalent in large/giant lesions, while BRAF mutations have also been identified in aggressive cases[14, 15]. Metabolomic studies further reveal consistent dysregulation of amino acid metabolism in CMN tissues, which correlates with key melanogenesis-related genes including TYR, SOX10, and MITF[16-18]. Despite the benign nature of most CMNs, their aesthetic impact, malignancy risk, and potential comorbidities underscore the need for timely therapeutic intervention and long-term surveillance, making the optimization of treatment outcomes a critical clinical focus. Treatment strategies of CMN require comprehensive consideration of lesion size, location, patient age, and malignant transformation risk, with each modality possessing inherent advantages and limitations[19]. Surgical excision, a traditional core therapy, excels in complete lesion removal to maximize malignancy risk reduction, particularly for small-to-medium and well-demarcated CMN[20]. However, it faces technical challenges in one-stage resection of large/giant CMN, often necessitating multiple staged surgeries[21]. Moreover, direct excision often requires skin grafting, which can cause new damage to the patient's healthy skin[22]. Tissue expansion is a surgical technique that increases skin area through mechanical stretching by implanting expanders subcutaneously and gradually injecting normal saline[23]. It is mainly used to repair skin defects after large CMN excision. The technique typically involves two stages: expander implantation with regular water injection in the first stage, and transfer of expanded skin flaps to repair defects in the second stage[24]. The expanded skin matches the surrounding tissue in color and texture, reducing donor site damage compared to traditional skin grafting[25]. Nevertheless, it has a prolonged treatment cycle, requires high patient tolerance, and carries risks of complications including hematoma, infection, and expander exposure, which demand standardized operation and postoperative care[26]. Laser therapy, characterized by minimal trauma and rapid recovery, is widely used for superficial and small-area CMN to improve pigmentation with little damage to surrounding tissues[27]. However, its limited penetration fails to eliminate deep dermal melanocytes, resulting in high recurrence rates, and it is less effective for large or deeply infiltrated lesions, with potential adverse reactions including hypopigmentation[28]. Dermabrasion, a commonly used dermatological technique, features simple operation, controllable trauma, and maximal preservation of skin integrity, making it suitable for large/giant CMN that cannot be completely resected in one stage[29]. Early treatment can effectively reduce pigment residue, but it cannot fully remove deep melanocytes or follicular extensions of CMN, leading to potential recurrence[4]. Its efficacy is affected by the operative depth: excessive depth may lead to scar hyperplasia or pigmentary abnormalities such as hyperpigmentation and hypopigmentation, whereas insufficient depth results in incomplete lesion removal[30, 31]. ADM has evolved as a well-established biomaterial in wound repair, with its clinical application initially gaining prominence in burn wound management[32]. Burn wounds are often characterized by extensive tissue damage and high risks of infection and scar contracture, and ADM has been proven effective in providing a protective barrier, promoting granulation tissue formation, and reducing pathological scarring in such scenarios[33]. With the advancement of dermatologic surgery, its application has been gradually extended to post-dermabrasion wound care. Dermabrasion causes controlled damage to the epidermal-dermal junction, and the resulting wound requires a stable microenvironment to support epithelial regeneration, which aligns with the inherent advantages of ADM[34, 35]. Unlike conventional wound dressings, ADM does not merely cover the wound but actively participates in the tissue repair process by mimicking the natural dermal structure, thereby reducing the risk of abnormal scar formation such as hyperplasia and pigmentation[36, 37]. In the context of CMN dermabrasion, this study further validates the clinical value of ADM. By applying ADM to the post-dermabrasion wound bed, we observed significant reductions in wound re-epithelialization time and VSS scores, confirming that ADM’s repair mechanisms are fully exerted in this specific clinical scenario. These findings not only extend the application scope of ADM in dermatologic surgery but also provide a reliable solution to the key challenge of wound healing after CMN dermabrasion, reinforcing the rationale for ADM as a preferred adjunctive therapy in such procedures. Our study has several limitations. First, as a retrospective study with a relatively small sample size, it may compromise statistical power and the generalizability of the results. Second, the follow-up duration, though no less than 1 year, is still insufficient to fully observe the potential recurrence and malignant transformation risks of CMN. Thirdly, most of the included patients were young children, whose ability to express their subjective feelings was limited, resulting in incomplete relevant data. Conclusions In conclusion, retrospectively comparing patients with and without ADM wound coverage post-dermabrasion, applying ADM after CMN dermabrasion significantly shortens wound re-epithelialization time and improves scar quality. No malignant transformation was noted during follow-up, making it a valuable clinical option for CMN treatment. Abbreviations ADM Acellular dermal matrix CMN Congenital melanocytic nevus TBSA Total body surface area CHEOPS Children's hospital of eastern ontario pain scale VSS Vancouver Scar Scale Declarations Ethics approval and consent to participate The protocol for the study was approved by the Ethics Committee of the 980th Hospital of the Joint Logistic Support Force of the PLA, and all investigations conformed with ethical principles. The data used in this study were anonymized before use. Consent for publication Not applicable. Clinical trial number Not applicable. Data availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Authors’ contributions Chenfei Li: conception, study design, and manuscript writing and revision. Chunhuan Zhang: data analysis, manuscript revision. Zeliang He: collection of data, data analysis, and manuscript writing. Ran Jing: study design, data analysis, manuscript writing and revision. Sihao Nie: collection of data, manuscript revision. Botian Jiang: study design, data analysis. Jingchen Bi: collection of data, manuscript revision. Xiaodong Li: conception, interpretation. All authors read and approved the final manuscript. Funding No funding. References Nathan S, Smetona J, Naran S, Bauer BS. Congenital Melanocytic Nevi. Clin Plast Surg. 2025;52(2):259–69. Al Sakka Amini R, Hakmi A, Hendi H, Abo Saada S, Etr A. 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Piscine-Derived Acellular Dermal Matrix in Upper Extremity Reconstruction. Eplasty. 2025;25:e10. Lou J, Zhu X, Xiang Z, Song J, Huang N, Jin G, et al. Efficacy of Acellular Dermal Matrix in Improving Clinical Outcomes in Pediatric Burns: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Pediatr Surg. 2025;60(5):162270. Zhou H, Huang C, Chen Y, Zhao T, Zhu F, Jun G et al. An In Situ Embedded B-MOF Sponge With Shape-Memory for All-in-One Diabetic Wound Therapy. Adv Healthc Mater. 2026:e05350. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 17 Mar, 2026 Editor invited by journal 19 Feb, 2026 Editor assigned by journal 18 Feb, 2026 Submission checks completed at journal 18 Feb, 2026 First submitted to journal 17 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-8900811\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":607330472,\"identity\":\"77662b4f-0fa9-421d-9c7e-5e2eeadc1311\",\"order_by\":0,\"name\":\"Chenfei Li\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Bethune International Peace Hospital\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Chenfei\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"},{\"id\":607330473,\"identity\":\"75da647d-1e02-43b8-9f37-39567212f74e\",\"order_by\":1,\"name\":\"Chunhuan Zhang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"The Third Hospital of Hebei Medical University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Chunhuan\",\"middleName\":\"\",\"lastName\":\"Zhang\",\"suffix\":\"\"},{\"id\":607330474,\"identity\":\"a63c74ab-3246-4279-8246-e1a0e6855108\",\"order_by\":2,\"name\":\"Zeliang He\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Bethune International Peace Hospital\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Zeliang\",\"middleName\":\"\",\"lastName\":\"He\",\"suffix\":\"\"},{\"id\":607330475,\"identity\":\"edabb6cd-d76e-4767-bb3a-f973c83fa783\",\"order_by\":3,\"name\":\"Ran Jing\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Bethune International Peace Hospital\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Ran\",\"middleName\":\"\",\"lastName\":\"Jing\",\"suffix\":\"\"},{\"id\":607330476,\"identity\":\"297b712f-4432-4164-96fb-fcf419be781e\",\"order_by\":4,\"name\":\"Sihao Nie\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Bethune International Peace Hospital\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Sihao\",\"middleName\":\"\",\"lastName\":\"Nie\",\"suffix\":\"\"},{\"id\":607330478,\"identity\":\"eff425d8-a82e-42bc-ac3b-59981d8a5b9b\",\"order_by\":5,\"name\":\"Botian Jiang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Bethune International Peace Hospital\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Botian\",\"middleName\":\"\",\"lastName\":\"Jiang\",\"suffix\":\"\"},{\"id\":607330480,\"identity\":\"98ce522d-ecae-4aea-a5d7-94696183e7dc\",\"order_by\":6,\"name\":\"Jingchen Bi\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Bethune International Peace Hospital\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jingchen\",\"middleName\":\"\",\"lastName\":\"Bi\",\"suffix\":\"\"},{\"id\":607330485,\"identity\":\"c6c14e9b-ec34-46ba-b08b-ccc410baf6ec\",\"order_by\":7,\"name\":\"Xiaodong Li\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3UlEQVRIie2Rqw7CMBSGmzSpKswWMxz6JE24hDlepMtIMZBM4pcwwQiv0kdgNEGBn0AMgwY3gaBgEBA6HKKfOuJ8OZcfIYfjDyFeok8XCHwP47wUVWBXmmwnOYslb6UkglMm7YqPpsDoZRuqNe20SqJrLIb2AAw2HDAlc0E18tKl+K7gRVzGcPR7uLErRH+C2P6gLFO0MlPOfJA0ZSHoEAGb2RRhbgEdKk27sSC4jjJ+KUiQUQ3l+WQwT05IxMJMUust7fUjypuJ0tP5tapMka6+K2/Q39odDofD8ZE7GxxHdXdrdoIAAAAASUVORK5CYII=\",\"orcid\":\"\",\"institution\":\"Bethune International Peace Hospital\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Xiaodong\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-02-17 11:55:09\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-8900811/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-8900811/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":104997826,\"identity\":\"5631c0fd-1347-41c2-8ac0-139d555f2752\",\"added_by\":\"auto\",\"created_at\":\"2026-03-19 16:24:43\",\"extension\":\"jpg\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":1141295,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eClinical manifestations and postoperative outcomes in patients with congenital melanocytic nevus (CMN) treated by dermabrasion combined with acellular dermal matrix (ADM) coverage. A. Preoperative view of a 4-year-old child with a giant CMN (diameter ≈22 cm) involving the trunk, showing dark brown pigmentation with irregular borders and scattered hair growth. B. Intraoperative view after dermabrasion: the lesion surface is uniformly abraded to the epidermal-dermal junction. C. During the first dressing change after the surgery, the condition of the wound could be observed. It was noted that the edge of the ADM began to dry out. D. The condition of the wound one month after the surgery\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"Figure1.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8900811/v1/f054afb71bdd9566f51f8bf6.jpg\"},{\"id\":105035409,\"identity\":\"c406ef19-ea57-480f-902a-4216bb79663d\",\"added_by\":\"auto\",\"created_at\":\"2026-03-20 07:26:02\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1710211,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8900811/v1/62451c7e-bd0c-4f55-8ede-0f1937c35820.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Acellular dermal matrix improves clinical prognosis and skin healing after dermabrasion for congenital melanocytic nevus\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eThe congenital melanocytic nevus (CMN), a common congenital cutaneous lesion, arises from abnormal migration and aggregation of melanocytes during embryonic development, which can involve multiple body parts with significant variations in lesion size and depth[\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. Among them, large and giant CMN (with large surface areas) not only impose heavy psychological and social burdens on patients due to appearance abnormalities but also pose threats to patients' life and health due to potential malignant transformation risks, highlighting an urgent clinical need for safe and effective therapeutic interventions[\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e]. Dermabrasion, a commonly used technique in dermatologic surgery, has matured over years of development[\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. Its core principle is to remove lesional tissue through mechanical grinding, and it is particularly suitable for large/giant CMN that cannot be completely resected in a single operation[\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e]. This technique features relatively simple operation, controllable damage to normal tissues, maximum preservation of skin integrity, without the need for skin grafting, thus avoiding damage to the donor site[\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]. However, the quality of wound healing after dermabrasion directly affects the overall therapeutic effect, which remains a key issue requiring further optimization in clinical practice.\\u003c/p\\u003e \\u003cp\\u003eAcellular dermal matrix (ADM) is a biomaterial that retains the natural dermal matrix structure after special treatment to remove cellular components[\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e]. With the development of tissue engineering technology, it has been widely used in various clinical fields. The main matrix components of ADM include collagen, elastic fibers, and glycosaminoglycans, which possess good biocompatibility, biodegradability, and tissue repair activity[\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e]. It can provide a stable microenvironment for wound healing, promote the proliferation and migration of epithelial cells, and induce granulation tissue growth[\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e]. In the clinical intervention of various diseases such as burn wound repair, chronic refractory wound treatment, and plastic and aesthetic tissue filling, ADM has shown significant effects in promoting wound healing and reducing scar formation[\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. Although ADM has long been applied in clinical practice, no previous studies have explored its application in dermabrasion for CMN, which leaves a research gap in optimizing wound repair outcomes after this specific surgical procedure.\\u003c/p\\u003e \\u003cp\\u003eTherefore, this study aimed to explore the application effect of ADM in wound repair after dermabrasion for CMN by comparing the postoperative clinical outcomes of patients with and without ADM application, so as to provide clinical references for optimizing the dermabrasion regimen for large/giant CMN and improving patient prognosis.\\u003c/p\\u003e\"},{\"header\":\"Materials and methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.1 Study design and patient population\\u003c/h2\\u003e \\u003cp\\u003e We retrospectively reviewed patients with CMN who underwent dermabrasion treatment at the 980th Hospital of the Joint Logistic Support Force of the PLA from March 2016 to June 2024. Inclusion criteria were CMN confirmed by clinical examination and pathological biopsy and undergoing dermabrasion treatment. Exclusion criteria were other benign or malignant skin tumors, infectious skin diseases, autoimmune diseases, local skin trauma history, and incomplete clinical data. Patients were divided into two groups (Groups A and B) based on whether ADM was applied for postoperative wound bed coverage: Group A was treated with ADM for wound bed coverage, while Group B received no ADM application. Data were collected and analyzed using anonymous methods in all cases, and the waiver of informed consent for this study was approved by the Ethics Committee of the 980th Hospital of the Joint Logistic Support Force of the PLA.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec4\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.2 Treatment and follow-up\\u003c/h2\\u003e \\u003cp\\u003eFor older children with CMN less than 20 cm in diameter, local infiltration anesthesia with 0.5% lidocaine with epinephrine solution (1:200,000) is administered, while general anesthesia is used for all other children. Intraoperatively, a motor-driven dermabrasion instrument produced by NSK Ltd. (Tokyo, Japan) is employed, featuring a pedal-controlled speed typically set at 20,000 rpm and spindle-shaped metal burrs made of stainless steel. During the procedure, the assistant stretches the skin of the surgical field tightly, and physiological saline is sprayed via a syringe for cooling to avoid thermal tissue damage caused by the heat generated by the rotating burrs. The depth of dermabrasion must be strictly controlled within the epidermal-dermal junction. For areas with thin skin such as the face and neck, low speeds and minimal pressure are crucial. After dermabrasion, the wound surface is compressed with saline-soaked gauze containing epinephrine (1:100,000) for 5\\u0026ndash;10 minutes. Once no obvious active bleeding is observed, the wound is covered with sterile petrolatum gauze or ADM (Jiangsu Unitrump Biomedical Technology Co., Ltd., Nantong, China), followed by appropriate pressure bandaging with 6\\u0026ndash;8 layers of sterile gauze and cotton pads.\\u003c/p\\u003e \\u003cp\\u003ePostoperatively, oral azithromycin 0.25g twice a day for 3 consecutive days is routinely prescribed for infection prophylaxis. Dressings are changed daily for 10\\u0026ndash;14 days until complete re-epithelialization of the wound is achieved. The follow-up duration is no less than 1 year, during which comprehensive physical examinations and special skin evaluations are conducted to screen for malignant lesions in the nevus itself and its surrounding areas (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.3 Data collection\\u003c/h2\\u003e \\u003cp\\u003eBasic patient information, including age and gender, was extracted from electronic medical records. At the first visit, the maximum lesion diameter and lesion area of CMN were measured. The lesion area was expressed as the percentage of total body surface area (TBSA). Additionally, the presence or absence of satellite lesions and hair on the lesion were recorded.\\u003c/p\\u003e \\u003cp\\u003ePerioperative indicators were obtained from surgical records, including anesthesia method, operation time, and intraoperative blood loss. Postoperative pain was evaluated using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) on the 3rd postoperative day during dressing changes. The time required for complete wound re-epithelialization was recorded based on daily dressing change records. When the surface of the wound is completely covered by new epithelium, the dressing no longer adheres to the wound, and there are no obvious signs of exudation, redness, swelling or other manifestations of infection or poor healing, all dressings can be removed at this time, and it can be determined as complete re-epithelialization. At the last follow-up, the Vancouver Scar Scale (VSS) was used to assess scar quality, which included evaluations of scar vascularity, pigmentation, height, and flexibility.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec6\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.4 Statistical analysis\\u003c/h2\\u003e \\u003cp\\u003eAll statistical analyses were performed using Statistical Package for Social Sciences 26.0 (IBM Corporation, Armonk, New York, USA). Continuous variables were expressed as mean \\u0026plusmn;standard deviation, whereas categorical variables were presented in frequencies and percentages. The independent sample \\u003cem\\u003et\\u003c/em\\u003e-test or Mann-Whitney \\u003cem\\u003eU\\u003c/em\\u003e test was used for numerical data, and the chi-square test was used to identify differences in frequency of categorical variables between groups. A multiple linear regression analysis was conducted to quantify the independent effect of group on the combined dependent variables. Variables with a \\u003cem\\u003eP\\u003c/em\\u003e-value\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05 were included in the regression model.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eA total of 59 patients (average age at first visit: 6.3\\u0026plusmn;2.0 years; 22 males [37.3%] and 37 females [62.7%]) who received dermabrasion treatment for CMN at The 980th Hospital of the Joint Logistic Support Force of the PLA were included in this study. Patients were divided into Group A and Group B based on whether ADM was used for postoperative wound bed coverage: Group A consisted of 32 cases with ADM applied for wound bed coverage, while Group B included 27 cases without ADM application. Comparison of baseline characteristics between the two groups revealed no statistically significant differences in age (\\u003cem\\u003eP\\u003c/em\\u003e = 0.672), gender (\\u003cem\\u003eP\\u003c/em\\u003e = 0.564), lesion size (\\u003cem\\u003eP\\u003c/em\\u003e = 0.640), lesion diameter (\\u003cem\\u003eP\\u003c/em\\u003e = 0.454), lesion location (\\u003cem\\u003eP\\u003c/em\\u003e = 0.862), presence of satellite lesions (\\u003cem\\u003eP\\u003c/em\\u003e = 0.117), or presence of hair on the lesion (\\u003cem\\u003eP\\u003c/em\\u003e = 0.778). These results indicate that the two groups had comparable baseline conditions (Table 1).\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 1\\u003c/strong\\u003e Baseline characteristics of patients with Congenital melanocytic nevus.\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellspacing=\\\"0\\\" cellpadding=\\\"0\\\" width=\\\"561\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eGroup A\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eGroup B\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cem\\u003eP\\u003c/em\\u003e value\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eNo. of\\u0026nbsp;patients\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e32\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e27\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eAge (years)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e6.17\\u0026plusmn;1.98\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e6.39\\u0026plusmn;2.10\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.672\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eGender (male/female)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e13/19\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e9/18\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.564\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eSize (% TBSA)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e4.74\\u0026plusmn;1.35\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e4.91\\u0026plusmn;1.38\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.640\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eLesion diameter (cm)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e24.21\\u0026plusmn;5.34\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e25.31\\u0026plusmn;5.92\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.454\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eLocation of lesion (Head and neck/Trunk/Extremities)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e6/16/10\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e4/13/10\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.862\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eSatellites (yes/no)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e7/25\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e11/16\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.117\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eHair on lesion (yes/no)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e13/19\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e10/17\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.778\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAbbreviations:\\u003c/strong\\u003e TBSA, Total body surface area.\\u003c/p\\u003e\\n\\u003cp\\u003eAmong all patients, 2 cases developed postoperative fever (1 case in Group A and 1 case in Group B) without obvious infectious signs, and 1 case of wound infection occurred in Group B. All complications were resolved within one week after targeted management, with no impact on the overall treatment outcome. One patient in Group A developed local tiny nodules 8 months postoperatively. Pathological biopsy confirmed benign proliferative nodules, and no additional intervention was needed. No malignant transformation was noted during long-term follow-up.\\u003c/p\\u003e\\n\\u003cp\\u003eIn terms of perioperative indicators, there were no statistically significant differences between the two groups in anesthesia methods (\\u003cem\\u003eP\\u003c/em\\u003e = 0.416), operation time (\\u003cem\\u003eP\\u003c/em\\u003e = 0.429), and intraoperative blood loss (\\u003cem\\u003eP\\u003c/em\\u003e = 0.554). The CHEOPS score evaluated on the 3rd postoperative day during dressing change also showed no significant difference between the two groups (\\u003cem\\u003eP\\u0026nbsp;\\u003c/em\\u003e= 0.075). Notably, there were significant statistical differences in wound re-epithelialization time and Vancouver Scar Scale (VSS) score between the two groups: the wound re-epithelialization time of Group A was significantly shorter than that of Group B (\\u003cem\\u003eP\\u003c/em\\u003e = 0.027), and the VSS score of Group A at the last follow-up was significantly lower than that of Group B (\\u003cem\\u003eP\\u003c/em\\u003e = 0.003) (Table 2).\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 2\\u0026nbsp;\\u003c/strong\\u003ePerioperative indicators and postoperative outcomes between the two groups.\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellspacing=\\\"0\\\" cellpadding=\\\"0\\\" width=\\\"566\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eGroup A\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eGroup B\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cem\\u003eP\\u003c/em\\u003e value\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eAnesthesia methods (local infiltration anesthesia / general anesthesia)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e6/26\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e3/24\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.416\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eOperating time (min)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e51.46\\u0026plusmn;13.57\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e48.70\\u0026plusmn;12.88\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.429\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eIntraoperative blood loss (ml)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e18.20\\u0026plusmn;4.27\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e18.88\\u0026plusmn;4.51\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.554\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eCHEOPS\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e4.59\\u0026plusmn;0.62\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e4.96\\u0026plusmn;0.94\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.075\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eRe-epithelization time (day)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e11.58\\u0026plusmn;0.84\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e12.14\\u0026plusmn;1.07\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.027\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eVSS\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e3.06\\u0026plusmn;0.88\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e3.93\\u0026plusmn;1.24\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.003\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAbbreviations:\\u003c/strong\\u003e CHEOPS, Children\\u0026apos;s Hospital of Eastern Ontario Pain Scale; VSS, Vancouver Scar Scale.\\u003c/p\\u003e\\n\\u003cp\\u003eTo further quantify the independent effect of ADM application on clinical outcomes, a multiple linear regression analysis was conducted, with group as the sole independent variable and re-epithelialization time/VSS score as dependent variables. The model was statistically significant (F = 9.637, \\u003cem\\u003eP\\u0026nbsp;\\u003c/em\\u003e\\u0026lt; 0.001). ADM application was an independent protective factor, significantly reducing re-epithelialization time (\\u0026beta; = -1.703, 95% CI: -2.415 to -0.991, \\u003cem\\u003eP\\u003c/em\\u003e \\u0026lt; 0.001) and VSS score (\\u0026beta; = -1.187, 95% CI: -1.605 to -0.769, \\u003cem\\u003eP\\u003c/em\\u003e \\u0026lt; 0.001) (Table 3). These findings confirm that covering the wound with ADM can effectively promote the process of wound epithelialization, shorten the healing time, and significantly improve the scar quality after dermabrasion.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 3\\u0026nbsp;\\u003c/strong\\u003eResults of multiple regression linear analysis.\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellspacing=\\\"0\\\" cellpadding=\\\"0\\\" width=\\\"566\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u0026beta;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e95% CI for\\u0026nbsp;\\u0026beta;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cem\\u003eP\\u003c/em\\u003e value\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eRe-epithelization time\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-1.703\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-2.415~-0.991\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003eVSS\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-1.187\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-1.605~-0.769\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAbbreviations:\\u003c/strong\\u003e VSS, Vancouver Scar Scale; \\u0026beta;, partial regression coefficient.\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eIn this study, we retrospectively analyzed CMN patients who underwent dermabrasion, comparing clinical outcomes between those with ADM wound coverage and those without. The results showed that ADM application significantly shortened wound re-epithelialization time and improved scar quality as evaluated by the VSS, providing important clinical evidence for enhancing CMN dermabrasion efficacy.\\u003c/p\\u003e\\n\\u003cp\\u003eCMN is a benign congenital cutaneous lesion derived from abnormal migration and aggregation of neural crest-derived melanocytes during embryonic development[11]. It exhibits substantial heterogeneity in size, morphology, and anatomical distribution, with clinical classification typically based on lesion size: small (\\u0026lt;1.5 cm), medium (1.5-20 cm), large (20-40 cm), and giant (\\u0026gt;40 cm)[12]. Large and giant CMN are clinically prominent due to their elevated lifetime risk of malignant transformation into melanoma and potential association with extracutaneous complications such as neurocutaneous melanosis[13]. From a molecular perspective, CMN pathogenesis is linked to postzygotic somatic mutations, with NRAS codon 61 mutations being the most prevalent in large/giant lesions, while BRAF mutations have also been identified in aggressive cases[14, 15]. Metabolomic studies further reveal consistent dysregulation of amino acid metabolism in CMN tissues, which correlates with key melanogenesis-related genes including TYR, SOX10, and MITF[16-18]. Despite the benign nature of most CMNs, their aesthetic impact, malignancy risk, and potential comorbidities underscore the need for timely therapeutic intervention and long-term surveillance, making the optimization of treatment outcomes a critical clinical focus.\\u003c/p\\u003e\\n\\u003cp\\u003eTreatment strategies of CMN require comprehensive consideration of lesion size, location, patient age, and malignant transformation risk, with each modality possessing inherent advantages and limitations[19]. Surgical excision, a traditional core therapy, excels in complete lesion removal to maximize malignancy risk reduction, particularly for small-to-medium and well-demarcated CMN[20]. However, it faces technical challenges in one-stage resection of large/giant CMN, often necessitating multiple staged surgeries[21]. Moreover, direct excision often requires skin grafting, which can cause new damage to the patient's healthy skin[22]. Tissue expansion is a surgical technique that increases skin area through mechanical stretching by implanting expanders subcutaneously and gradually injecting normal saline[23]. It is mainly used to repair skin defects after large CMN excision. The technique typically involves two stages: expander implantation with regular water injection in the first stage, and transfer of expanded skin flaps to repair defects in the second stage[24]. The expanded skin matches the surrounding tissue in color and texture, reducing donor site damage compared to traditional skin grafting[25]. Nevertheless, it has a prolonged treatment cycle, requires high patient tolerance, and carries risks of complications including hematoma, infection, and expander exposure, which demand standardized operation and postoperative care[26]. Laser therapy, characterized by minimal trauma and rapid recovery, is widely used for superficial and small-area CMN to improve pigmentation with little damage to surrounding tissues[27]. However, its limited penetration fails to eliminate deep dermal melanocytes, resulting in high recurrence rates, and it is less effective for large or deeply infiltrated lesions, with potential adverse reactions including hypopigmentation[28]. Dermabrasion, a commonly used dermatological technique, features simple operation, controllable trauma, and maximal preservation of skin integrity, making it suitable for large/giant CMN that cannot be completely resected in one stage[29]. Early treatment can effectively reduce pigment residue, but it cannot fully remove deep melanocytes or follicular extensions of CMN, leading to potential recurrence[4]. Its efficacy is affected by the operative depth: excessive depth may lead to scar hyperplasia or pigmentary abnormalities such as hyperpigmentation and hypopigmentation, whereas insufficient depth results in incomplete lesion removal[30, 31].\\u003c/p\\u003e\\n\\u003cp\\u003eADM has evolved as a well-established biomaterial in wound repair, with its clinical application initially gaining prominence in burn wound management[32]. Burn wounds are often characterized by extensive tissue damage and high risks of infection and scar contracture, and ADM has been proven effective in providing a protective barrier, promoting granulation tissue formation, and reducing pathological scarring in such scenarios[33]. With the advancement of dermatologic surgery, its application has been gradually extended to post-dermabrasion wound care. Dermabrasion causes controlled damage to the epidermal-dermal junction, and the resulting wound requires a stable microenvironment to support epithelial regeneration, which aligns with the inherent advantages of ADM[34, 35]. Unlike conventional wound dressings, ADM does not merely cover the wound but actively participates in the tissue repair process by mimicking the natural dermal structure, thereby reducing the risk of abnormal scar formation such as hyperplasia and pigmentation[36, 37]. In the context of CMN dermabrasion, this study further validates the clinical value of ADM. By applying ADM to the post-dermabrasion wound bed, we observed significant reductions in wound re-epithelialization time and VSS scores, confirming that ADM’s repair mechanisms are fully exerted in this specific clinical scenario. These findings not only extend the application scope of ADM in dermatologic surgery but also provide a reliable solution to the key challenge of wound healing after CMN dermabrasion, reinforcing the rationale for ADM as a preferred adjunctive therapy in such procedures.\\u003c/p\\u003e\\n\\u003cp\\u003eOur study has several limitations. First, as a retrospective study with a relatively small sample size, it may compromise statistical power and the generalizability of the results. Second, the follow-up duration, though no less than 1 year, is still insufficient to fully observe the potential recurrence and malignant transformation risks of CMN. Thirdly, most of the included patients were young children, whose ability to express their subjective feelings was limited, resulting in incomplete relevant data.\\u003c/p\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eIn conclusion, retrospectively comparing patients with and without ADM wound coverage post-dermabrasion, applying ADM after CMN dermabrasion significantly shortens wound re-epithelialization time and improves scar quality. No malignant transformation was noted during follow-up, making it a valuable clinical option for CMN treatment.\\u003c/p\\u003e\"},{\"header\":\"Abbreviations\",\"content\":\"\\u003cp\\u003eADM \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; Acellular dermal matrix\\u003c/p\\u003e\\n\\u003cp\\u003eCMN \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; Congenital melanocytic nevus\\u003c/p\\u003e\\n\\u003cp\\u003eTBSA \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;Total body surface area\\u003c/p\\u003e\\n\\u003cp\\u003eCHEOPS \\u0026nbsp; Children\\u0026apos;s hospital of eastern ontario pain scale\\u003c/p\\u003e\\n\\u003cp\\u003eVSS \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; Vancouver Scar Scale\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eEthics approval and consent to participate\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe protocol for the study was approved by the Ethics Committee of the 980th Hospital of the Joint Logistic Support Force of the PLA, and all investigations conformed with ethical principles. The data used in this study were anonymized before use.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eClinical trial number\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData availability\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting interests\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare that they have no competing interests.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthors\\u0026rsquo; contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eChenfei Li: conception, study design, and manuscript writing and revision. Chunhuan Zhang: data analysis, manuscript revision. Zeliang He: collection of data, data analysis, and manuscript writing. Ran Jing: study design, data analysis, manuscript writing and revision. Sihao Nie: collection of data, manuscript revision. Botian Jiang: study design, data analysis. Jingchen Bi: collection of data, manuscript revision. Xiaodong Li: conception, interpretation. All authors read and approved the final manuscript.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNo funding.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eNathan S, Smetona J, Naran S, Bauer BS. Congenital Melanocytic Nevi. Clin Plast Surg. 2025;52(2):259\\u0026ndash;69.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAl Sakka Amini R, Hakmi A, Hendi H, Abo Saada S, Etr A. A successful serial excision surgery for congenital melanocytic nevus in a child: A case report. Int J Surg Case Rep. 2025;130:111297.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAmatto I, Nunes DC, Perri LB, Andrade MF, Santos TC, Botelho S, et al. Diamond tip dermabrasion in the treatment of hyperpigmentation of the female intimate region: a cross-over controlled trial. J Sex Med. 2025;22(10):1780\\u0026ndash;2.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMologousis MA, Tsai SY, Tissera KA, Levin YS, Hawryluk EB. Updates in the Management of Congenital Melanocytic Nevi. Child (Basel). 2024;11(1).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLin Q, Xie Z, Qu F, Xu H, Jiao H. Treatment Modalities, Efficacy, and Complications in Nasal Congenital Melanocytic Nevi: A Systematic Review. J Craniofac Surg. 2025.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLee KI, Song WS, Han SK, Jeong SH, Dhong ES. Longitudinal Assessment of Facial Scars After Acellular Dermal Matrix Grafting Post-Skin Cancer Resection: Focus on Color and Contraction. Plast Reconstr Surg; 2025.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCrombie RE, Witherel CE. Preliminary Analysis of American Burn Association National Burn Repository to Investigate Impact of Cellular, Acellular, and Matrix-Based Products Use in Burn Wound Management. J Burn Care Res. 2026;47(1):85\\u0026ndash;95.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTian X, Li B. Clinical efficacy and safety analysis of xenogeneic acellular dermal matrix in repairing ear skin defects: a single-center prospective study. Acta Otolaryngol. 2026:1\\u0026ndash;11.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eZhang S, Hu Y, Li X. Comment on Safety and Efficacy of Micronized Acellular Dermal Matrix Injection for Correction of Moderate to Severe Nasolabial Folds: A Double-Blind, Multicenter, Randomized Controlled, Non-inferior Clinical Trial. Aesthetic Plast Surg. 2026.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDavila-Diaz R, Jaimes-Duran EM, Gutierrez-Alvarez M, Cortes-Aguilar C, Camarillo Reyes LA, Mendizabal Velazquez MA, et al. Reconstruction of Electrical Burn Wounds Using Acellular Dermal Matrix: A Case Report and Literature Review. Cureus. 2025;17(8):e90071.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eYu L, Harms PW, Pouryazdanparast P, Kim DS, Ma L, Fullen DR. Expression of the embryonic morphogen Nodal in cutaneous melanocytic lesions. Mod Pathol. 2010;23(9):1209\\u0026ndash;14.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMacneal P, Syed HA, Patel BC. Congenital Melanocytic Nevi. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright \\u0026copy; 2025. StatPearls Publishing LLC.; 2025.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRuth J. Congenital melanocytic nevus syndrome: An association between congenital melanocytic nevi and neurological abnormalities. Semin Pediatr Neurol. 2024;51:101153.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHanft KM, Hamed E, Kaiser M, W\\u0026uuml;rtemberger J, Schneider M, Pietsch T, et al. Combinatorial effects of azacitidine and trametinib on NRAS-mutated melanoma. Pediatr Blood Cancer. 2022;69(4):e29468.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAgrawal S, Guo R. Melanocytic neoplasm with novel EPS15:BRAF fusion and congenital features. Hum Pathol. 2025;165:105790.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSamson L, Worrell S, Salgado CM, Medina-Ceballos E, Wu D, Skvarca LB, et al. Aberrant neural crest cells migration leads to melanocyte presence in the umbilical cord. Placenta. 2026;175:1\\u0026ndash;6.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eYu Q, Aimaier R, Chung MH, Cui X, Li Y, Wang Z, et al. Establishment and characterization of an immortalized human giant congenital melanocytic nevi cell line. Pigment Cell Melanoma Res. 2022;35(3):356\\u0026ndash;68.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFuiten AM, Fankhauser RG, Smit DJ, Stark MS, Enright TF, Wood MA, et al. Genetic analysis of multiple primary melanomas arising within the boundaries of congenital nevi depigmentosa. Pigment Cell Melanoma Res. 2021;34(6):1123\\u0026ndash;30.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFan X, Qiao Y, Sun L, Zhang Y, Wu S. Comprehensive nursing intervention for postoperative scar management in preschool children with congenital melanocytic nevus. Front Pediatr. 2025;13:1657846.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLuo XY, Hu Y, Yang WJ, Song XZ, Peng JZ. The W-Plasty Serial Excision Method for Treating Medium Congenital Melanocytic Nevi: A Retrospective Analytical Study. Dermatol Surg. 2024;50(10):908\\u0026ndash;12.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTan K, Zhang J. Geometric-Marking Quantification for First-Stage Excision of Large Congenital Melanocytic Nevi. Clin Cosmet Investig Dermatol. 2025;18:1865\\u0026ndash;72.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGout HA, Fledderus AC, Lokhorst MM, Pasmans S, Breugem CC, Lapid O, et al. Safety and effectiveness of surgical excision of medium, large, and giant congenital melanocytic nevi: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg. 2023;77:430\\u0026ndash;55.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLiang B, Bai R, Wang J, Shi S, Guo Y, Wang Q, et al. Innovative applications of acellular adipose matrix derived film in skin soft tissue expansion. Biomater Adv. 2025;173:214291.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTang H, Xue Z, Li Y, Dong Z, Liao Y. Internal Tissue Expansion Induces Outward Migration of ADSCs From the Subcutaneous Fat Flap to Promote Skin Regeneration of the Expanded Area. Stem Cells Int. 2025;2025:8680042.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLuo SS, Yang Z, Ma N, Chen S, Li YQ. Sizeable Facial and Cervical Defect Repair using a Medial Arm Flap Combined With the Tissue Expansion Technique: Clinical Applications and Fifteen-year Follow-up. J Craniofac Surg. 2024;35(2):593\\u0026ndash;6.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eXue Z, Hu D, Tang H, Xue M, Zhu Y, Li Y, et al. Mechanical force regulates the paracrine functions of ADSCs to assist skin expansion in rats. Stem Cell Res Ther. 2024;15(1):250.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTsai SY, Buta MR, Bojovic B, Mologousis MA, Anderson RR, Hawryluk EB, et al. Combination Laser Treatment in Procedural Management of Congenital Melanocytic Nevi. Lasers Surg Med. 2025;57(4):306\\u0026ndash;11.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBray FN, Shah V, Nouri K. Laser treatment of congenital melanocytic nevi: a review of the literature. Lasers Med Sci. 2016;31(1):197\\u0026ndash;204.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKamboj S, Olumesi KR, Immaneni S, Blalock TW. Intraoperative Interventions for Scar Optimization in Cutaneous Surgery: A Systematic Review. Dermatol Surg. 2025.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePatil AS, Patil AS, Ugare P, Jain E, Masareddy RS. Advancements in hyperpigmentation management: exploring conventional methods, phytoconstituents, novel approaches, and instrumental techniques. J Cosmet Laser Ther. 2025;27(1\\u0026ndash;2):1\\u0026ndash;16.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePotter K, Konda S, Ren VZ, Wang AL, Srinivasan A, Chilukuri S. Techniques for Optimizing Surgical Scars, Part 3: Erythema, Hyperpigmentation, and Hypopigmentation. Skinmed. 2018;16(2):113\\u0026ndash;7.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCzerny-Bednarczyk K, Słaboń A, Zi\\u0026oacute;łkowska K, Klama-Baryła A, Wielg\\u0026oacute;recki A, Gierek M, et al. Tissue engineering as a tool in a novel approach to the comprehensive treatment and management of a deeply and extensively burned patient: case report. Cell Tissue Bank. 2025;27(1):2.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eZhang JL, Liu SH, Wang DY, Jiang MJ, Xie WG, Xi MM. [Effects of acellular allogeneic dermis combined with autologous split-thickness skin grafts in repairing deep burn wounds in head, face, neck, and torso in children]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2025;41(6):569\\u0026ndash;76.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAbdulmajid L, Bosisio FM, Brems H, De Vlieger G, Garmyn M, Segers H, et al. An update on congenital melanocytic nevus syndrome: A case report and literature review. J Cutan Pathol. 2021;48(12):1497\\u0026ndash;503.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eShahriari S, Whisonant C, Kuhn J, Chavez T, Harrison J, McDonald C, et al. Piscine-Derived Acellular Dermal Matrix in Upper Extremity Reconstruction. Eplasty. 2025;25:e10.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLou J, Zhu X, Xiang Z, Song J, Huang N, Jin G, et al. Efficacy of Acellular Dermal Matrix in Improving Clinical Outcomes in Pediatric Burns: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Pediatr Surg. 2025;60(5):162270.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eZhou H, Huang C, Chen Y, Zhao T, Zhu F, Jun G et al. An In Situ Embedded B-MOF Sponge With Shape-Memory for All-in-One Diabetic Wound Therapy. Adv Healthc Mater. 2026:e05350.\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-surgery\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"bsur\",\"sideBox\":\"Learn more about [BMC Surgery](http://bmcsurg.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/bsur/default.aspx\",\"title\":\"BMC Surgery\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Congenital melanocytic nevus, acellular dermal matrix, dermabrasion\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-8900811/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-8900811/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground\\u003c/h2\\u003e \\u003cp\\u003eCongenital melanocytic nevus (CMN) is associated with aesthetic concerns and potential malignant transformation risks, with dermabrasion being a common therapeutic option. Postoperative wound healing remains a key challenge, and the value of acellular dermal matrix (ADM) in optimizing this process needs verification.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e \\u003cp\\u003eWe retrospectively included a series of patients with CMN who underwent dermabrasion at our hospital from March 2016 to June 2024. Patients were divided into Group A (ADM wound coverage) and Group B (no ADM application). Basic patient information, lesion-related characteristics, perioperative indicators, wound re-epithelialization time, and Vancouver Scar Scale (VSS) scores were collected. Multiple linear regression analysis was performed to quantify the independent effect of ADM application on outcomes.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e \\u003cp\\u003eA total of 59 patients were included (Group A: 32 cases; Group B: 27 cases). There were no significant differences between the two groups in age, gender, lesion size, lesion diameter, lesion location, presence of satellite lesions or presence of hair on the lesion (\\u003cem\\u003eP\\u003c/em\\u003e\\u0026gt;0.05). No significant differences were observed in anesthesia method (\\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.416), operation time (\\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.429), intraoperative blood loss (\\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.554), or CHEOPS scores (\\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.075). Group A had shorter re-epithelialization time (\\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.027) and lower VSS scores (\\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.003) than Group B. Multiple linear regression confirmed ADM application as an independent protective factor for shorter re-epithelialization time (β=-1.703, 95% CI: -2.415~-0.991, \\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001) and lower VSS scores (β=-1.187, 95% CI: -1.605~-0.769, \\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001). No malignant transformation was noted during long-term follow-up.\\u003c/p\\u003e\\u003ch2\\u003eConclusions\\u003c/h2\\u003e \\u003cp\\u003eADM application after CMN dermabrasion significantly shortens wound healing time and improves scar quality, providing a valuable clinical option for CMN treatment.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Acellular dermal matrix improves clinical prognosis and skin healing after dermabrasion for congenital melanocytic nevus\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-03-19 16:23:11\",\"doi\":\"10.21203/rs.3.rs-8900811/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-03-17T05:29:35+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvited\",\"content\":\"\",\"date\":\"2026-02-19T07:25:51+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-02-18T08:49:05+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-02-18T08:48:42+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"BMC Surgery\",\"date\":\"2026-02-17T11:36:39+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-surgery\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"bsur\",\"sideBox\":\"Learn more about [BMC Surgery](http://bmcsurg.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/bsur/default.aspx\",\"title\":\"BMC Surgery\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"97f84a77-22ac-4279-a96e-cb125063dafa\",\"owner\":[],\"postedDate\":\"March 19th, 2026\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"under-review\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-03-19T16:23:11+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-03-19 16:23:11\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-8900811\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-8900811\",\"identity\":\"rs-8900811\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}