After an overview of the definition, characteristics, and treatment of congenital macromegaly, here we focus on the application of continuous skin soft tissue expansion technique in the treatment of macromegaly. First of all, we will briefly introduce what is soft tissue dilation technique. Soft tissue expansion technique of skin is to increase the volume of dilator by implanting it under normal skin soft tissue and injecting liquid into the expansion capsule through an injection jug to make it exert pressure on the surface skin soft tissue, so that the tissue and skin cells divide and proliferate and the cell gap is enlarged, thus increasing the skin area, or extending the skin by mechanical traction outside the skin and using the newly increased skin soft tissue for A method of tissue repair. The definition is a bit complicated, in layman’s terms, you can imagine the expander as a balloon that can be filled with water, the doctor buried the balloon under the skin, after a period of time, began to pump water into the balloon, the balloon is getting bigger and bigger, the tension on its surface skin, the skin will have two responses to the tension: 1, skin cells began to proliferate, that is, to produce new skin; 2, the surrounding loose skin will be pulled over This reaction is similar to the expansion of the skin in the abdomen when a mother is pregnant. In this way, additional skin is created around the lesion that needs to be repaired, partly new and partly “snatched”. Doctors can apply this extra skin to repair the lesion. The tissue expansion technique was first introduced in the 1970s and has been widely used because of its many advantages, the most prominent of which is that the expanded skin is similar in color and texture to the surrounding normal skin, allowing for a good repair. The most difficult aspect of the treatment of giant nevi is the large amount of normal skin needed to repair the wound caused by the removal of the giant nevus. Therefore, tissue expansion techniques are commonly used for the treatment of giant nevi. However, in most cases, the amount of skin that can be expanded at one time is not enough to repair the entire giant nevus. So it needs to be expanded again or even several times, and we call this continuous multiple expansions as continuous skin soft tissue expansion technique, or continuous expansion for short. In our center, the continuous expansion technique has been carried out in nearly 100 cases and is a routine operation, but the continuous expansion technique is not simply a superposition of dilator surgery, but a unique technique with its own technical points and precautions: 1. According to our experience, the first expansion needs to be sufficient, that is, to reach the maximum efficiency of the dilator, and it is necessary to inject more water than the capacity of the dilator, sometimes even Sometimes it is necessary to expand to twice or three times of the capacity, which we call over-expansion.2. The second surgery is especially important, at this time, parents cannot only see the nevus in front of them, but ask the doctor to remove as much nevus as possible, at this stage, because dilator implantation is a challenge to the incision healing, so the tension of the incision in this period cannot be too large, otherwise it will cause the failure of the surgery because the incision is not long; at the same time, because the trauma surface is large in this period, there is a lot of exudate, and the postoperative The postoperative drainage and pressure dressing are critical because of the large wound surface and exudate, and it will be more difficult to develop a hematoma or seroma after surgery. The dilator implanted for the second time tends to have a larger volume and more water will be injected during the operation, and the dilator will be prominent and take shape after the stitches are removed.3. Parents will find that the second time the dilatation will be faster than the first time, and soon the dilator will be very large, and parents are full of joy, but they find that the nevus removed in the third operation is very small. Because the expansion of the first time has already used the part of the skin that was robbed, and the newborn skin is very limited, so the second expansion still needs to be given an overdraw and sufficient time. In this way, the above treatment sessions are repeated, and the number of consecutive expansions depends on the size of the giant mole, as little as two times or as many as four or five times.4. Such a treatment process is very long, taking a year to two years, and parents may be anxious to see that there is not much piece of giant mole left, so why does the doctor say there is a possibility of another expansion? In fact, since the third surgery, the lesion removed by the surgery is not only the mole, but also the incision scar, and the scar has the characteristic of contracture, so the trauma formed after the scar removal is much larger than the surface area of the scar, so it seems that there is not much left, but the trauma formed during the surgery will be large. After reading the above, parents may have concluded the advantages and disadvantages of continuous dilation by themselves. Its advantages are fewer additional incisions and better results; its disadvantages are more frequent, longer and more expensive surgeries, but sometimes this is really the only way to completely remove a giant mole. Some parents may ask if there is a limit to the number of consecutive dilation. We believe that continuous dilation can be performed as long as the quality of the dilation skin is good, but the skin thins further with each dilation and the efficiency of the dilation continues to decrease. Some doctors may choose to remove the dilatation period for 2 months before the second dilator implantation to reduce the risk of the procedure. We believe that this is unnecessary and that simultaneous implantation of dilators is feasible and safe, while reducing the number of surgeries and anesthesia for the child. The following is the treatment procedure of a small patient with a giant nevus on the back and lateral chest, who underwent three consecutive dilatations to complete the removal and repair of the giant nevus. The second dilation was completed before the surgery and the third dilation was completed after the surgery and the stitches were removed.