Objective To investigate the surgical treatment and curative effect of hemangioma and vascular malformation in body surface. Methods From May 2003 to December 2006, 145 patients with hemangioma or vascular malformation (81 males and 64 females, aging from 2 months to 40 years with median of 17 years) were treated with surgical therapy. The course of disease was from 2 months to 40 years. The locations were head and face in 85 cases, extremities in 34 casesand trunk in 26 cases. The size ranged from 1 cm × 1 cm to 27 cm × 24 cm. Wounds were sutured directly after lesions excision in 40 cases, were repaired with 3 cm × 2 cm-18 cm × 11 cm local flap transferring in 21 cases (donor site sutured directly in 18 and free skin grafted in 3) and with 5 cm × 3 cm-27 cm × 18 cm middle-thick skin graft in 84 cases (abdominal skin donor site sutured directly in 61, thigh skin donor site thin-partial-thickness grafted in 5 and skin in-situ regrafted in 18). Results The pathological results showed 38 cases of capillary hemangioma, 23 cases of venular malformation, 67 cases of venous malformation, 15 cases of arteriovenous malformation and 2 cases of lymphatic malformation. Six of 84 cases receiving free skin graft had partial skin necrosis; one case compl icating by skull exposure achieved heal ing after local fascial flap transferring and other 5 cases achieved heal ing by second intention after dressing changes. Other free skin graft survived. All the donor sites healed by first intention. All patients were followed up for 1-3 years. Recurrence occurred in 12 cases 6 months to 2 years after operation, including 4 cases of arteriovenous malformation, 7 cases of venous malformation and 1 case of venular malformation. They were cured after second operation. The others achieved good results with no recurrence. Conclusion Extensive and thorough excision was the effective way to cure hemangioma and vascular malformation in body surface. All cases should be followed up closely to deal with recurrence promptly.
Objective To study the cl inical features of infantile hemangioma and vascular malformation, to find out a proper strategy of deal ing with them. Methods From March 2000 to August 2007, 2 957 cases of infantile hemangioma and vascular malformation were treated, including 860 operative cases and 2 097 non-operative cases. There were 441 male and419 female patients in operation group, aging 6 months to 18 years (median 5 years). In 1 950 hemangioma patients of nonoperation group, there were 575 male and 1 375 female patients, aging 1 month to 14 years (median 6 months); in 147 vascular malformation patients of non-operation group, there 67 male and 80 female patients, aging 2 years to 17 years (median 7 years). In non-operative group, 147 vascular malformation patients and 1 525 infantile hemangioma patients were followed up without any medical intervention, while other 425 hemangioma patients recceived triamcinolone plus dexamethasone intralesional injection treatment. All the treatments and outcomes were recorded. Results Vascular malformation cases and infantile hemangioma cases presented totally different cl inical features. To the deadl ine of this study, 522 (34%) of 1 525 un-intervented hemangioma cases turned into involuted phase and 383 (90%) of 425 cases receiving triamcinolone plus dexamethasone intralesional injection treatment turned into involuted phase after injection treatment; no regression was noted in 147 cases of vascular malformation. The constituent ratio of infantile hemangioma in 860 operative cases was decreased gradually and the constituent ratio of vascular malformation was increased gradually as the age increasing. Conclusion Infantile hemangioma has a distinct l ife pattern. Except several specific cases need medical intervention for their special location or large ambit and unacceptable growth, most infantile hemangioma need no medical intervention. Most vascular malformations can not regress spontaneously, proper intervention is in need.