Pasichnyk O. Clinical and epidemiological features of pigmented skin lesions in children and improvement of diagnostics and surgical treatment (experimental and clinical study)

The study is devoted to the problem of the choice of therapeutic and diagnostic measures and the method of treatment of children with pigmented skin lesions. The aim of the study was to improve the results of surgical treatment of children with pigmented skin lesions by individual surgical management, development and implementation of new operative approaches with the development of diagnostic and treatment algorithms, prevention of prolonged growth/ recurrence of tumors. To achieve this goal, an improved method of postoperative wound closure was developed (Patent of Ukraine for invention №121938 Ukraine UA МПК А61В 17/04) "Method of suturing postoperative wounds with different thickness of subcutaneous fat"). An experimental part of the scientific research revealed that minimal histological and morphometric changes in tissue lesions in skin biopsies of experimental animals were characteristic at all stages of the study in a group of animals which tissue excision was performed with a scalpel, and maximum pathomorphological changes were observed in biopsy with a monopolar coagulator. A geometric spatial model for determining the radical parameters and shape of the surgical wound during the removal of pigmented skin lesions, which is based on the principles of microscopically controlled surgery, has been developed. To select an adequate method of pigmented skin lesions excision, the level of CCL2 / MCP-1 as a prooncogenic marker in the serum of patients in the postoperative period with different methods of their excision was determined. An algorithm for diagnosis and complex treatment of skin pigmented nevi in children based on a multidisciplinary approach was developed, which allowed to increase the value of the average total quality of life of patients in the prospective period by 14.5% compared with patients in the retrospective period (4.74 + 0.07 points against 4.04 + 0.12 points (p <0.05).