Simple and Easy Surgical Technique for Infantile Hemangiomas

Intralesional Excision and Primary Closure

Tadashi Nomura, MD, PhD; Takeo Osaki, MD; Hiroyoshi Ishinagi, MD; Hirotaka Ejiri, MD, PhD; Hiroto Terashi, MD, PhD

Disclosures

ePlasty. 2015;15 

In This Article

Abstract and Introduction

Abstract

Objective Infantile hemangioma (IH) is a benign vascular tumor that gradually shrinks over several years. Involuting or involuted IHs usually retain their shape, however, and result in redundant skin or conspicuous scarring due to ulceration in the proliferating phase. We present a case series of 12 patients who underwent intralesional excision and primary closure for treatment of involuting or involuted IH.

Methods Twelve patients (5 boys, 7 girls) underwent our treatment method for involuting or involuted IH. A blinded assessor evaluated clinical result of each patient.

Results Surgical results were excellent in 4 patients, good in 6, and fair in 2. A small dog ear was prominent in 1 patient; nevertheless, all parents were satisfied with the results.

Conclusions Intralesional excision and primary closure for treatment of involuting or involuted IH is an easy and simple procedure that does not result in dog-ear formation or elongated residual scarring.

Introduction

Infantile hemangioma (IH) is a benign vascular tumor that grows rapidly until the age of 1 year and then gradually shrinks over several years thereafter. Infantile hemangioma has a high incidence rate, affecting approximately 10% of children.[1] Many interventions for IH have been reported. In particular, pulsed dye laser treatment is effective for small or superficial lesions,[2] whereas oral steroids or propranolol treatment is recommended for problematic IHs.[3,4] These treatments are effective for IHs in the proliferating phase. However, involuting or involuted IHs usually retain their shape and result in redundant skin or conspicuous scarring due to ulceration in the proliferating phase.[5] In the present report, we describe a simple excision method for treatment of involuting or involuted IH based on serial excision.

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