Methods From January 2015 to December 2016, 7 cases of congenital giant nevus of upper extremity were treated with pedicled expanded trunk flap. The operation can be divided into 3 stages: Tissue expanders were implanted into the trunk in Stage Ⅰ; After proper expansion, the giant nevus was resected and the expanded flap was transferred to the upper extremity to establish blood circulation in Stage Ⅱ; Pedicle transection was performed in Stage Ⅲ.

Results The size of the nevus was 16 cm×10 cm to 30 cm×14.5 cm, all giant nevi were completely removed. All patients were followed up for 6 to 39 months (mean 25.5 months). All the flaps survived with good blood supply, the color and texture were similar to the surrounding normal skin, and there were no complications such as infection, hematoma, necrosis and contracture. For cases involving periarticular skin, postoperative joint movements were normal. Expander exposure was noted in 1 case, but had no negative effect on the result.

Conclusion Pedicled expanded trunk flap can provide large areas of normal skin and avoid multiple expansions. It is practical and effective. It is a reliable method to repair the defect of upper extremity.