[Surgical treatment of hemangioma and vascular malformation in body surface].

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 cases and trunk in 26 cases. The size ranged from 1 cm x 1 cm to 27 cm x 24 cm. Wounds were sutured directly after lesions excision in 40 cases, were repaired with 3 cm x 2 cm-18 cm x 11 cm local flap transferring in 21 cases (donor site sutured directly in 18 and free skin grafted in 3) and with 5 cm x 3 cm-27 cm x 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 complicating by skull exposure achieved healing after local fascial flap transferring and other 5 cases achieved healing 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.