Radicalism of the operating field in the removal of pigmented nevi in children

Abstract

The purpose of the study – to increase the efficiency of determining the degree of radicalism in the removal of pigmented skin nevi in children, taking into account the thickness of the hypodermis in different anatomical parts of the body. Materials and methods of research. The work was performed on the basis of the Department of Oncohematology of Vinnytsia Regional Children’s Clinical Hospital in the period from 2018 to 2020. The clinical distribution of features of surgical interventions for skin pigmented nevi included analysis of medical records of outpatients and inpatients (120 documents). The age of patients of both sexes ranged from 3 to 16 years. Patients with localization of pigmented neoplasms in different areas were analyzed. Results. The model for calculating the planar parameters of the surgical wound is based on the ratio of the size of the removed tissues in the form of ellipses at the level of the skin and at the level of the deep fascia, taking into account the thickness of the hypodermis. For a more simplified perception of the logic of the calculation, the shape of the operating space is proposed to be considered as a cone. Geometrically, the computational model is in the form of a triangle, the vertex of which unfolds at an angle of 25̊, and which is an inverted by 180̊ analogue of classical angle of operational action. Conclusions. The proposed method of determining the radicalism of removal of pigmented skin nevi by mathematical calculation of the ratio of areas of removed tissues at the skin level and at the level of the aponeurosis taking into account the thickness of the hypodermis in different parts of the body allows to calculate individual surgical wound parameters. Due to the large number of pigmented nevi of different localization in childhood and a careful approach to determining the indications for surgical treatment in the last decade there has been an extensional annual increase in the number of operated children.