Rational treatment of pediatric hemangiomas and vascular malformations

Hemangiomas and vascular malformations are the most common group of pediatric blood surface disorders that affect not only health but also aesthetics. The treatment of hemangiomas varies from site to site, so a proper treatment not only allows the disease to be treated, but also greatly reduces the aesthetic impact. Plastic surgery treatment is characterized by more cosmetic features of repair and reconstruction and the extensive use of lasers. The majority of hemangiomas are in a state of constant growth, with some growing rapidly and a very small percentage regressing spontaneously. Among all treatment methods, surgical excision should be the first choice, while those that cannot be excised should be suppressed or delayed in growth. The common treatment methods are: surgical excision: plastic surgery uses minimally invasive plastic surgery techniques for surgical treatment, in addition to comprehensive measures such as topical scar inhibiting drugs and local pressure bandages to suppress the growth of post-operative scar to the lowest point, the sutures used are 6-0 and 7-0, i.e., thinner than a hair, so that the The incisions heal with only very small linear scars, and no stitching eyes are visible; the disadvantage is that parents are generally fearful of surgery and anesthesia, but this is the method with the highest cure rate, and general anesthesia has no effect on intelligence, and no chemical or radioactive substances remain in the body. Laser treatment: It is suitable for capillary hemangioma on the epidermis, which can leave no scar or very slight scar. It is especially suitable for hemangioma with small area, or large area with difficulty in surgical removal of multiple parts, and laser can shrink and control its growth in preparation for surgery. The advantages are that there is no anesthesia and no surgery, which is easy for parents to accept. The disadvantages are that only a small percentage of hemangiomas are suitable, the cure rate is not as high as surgery, there is pain during treatment, and scars may be produced. Cryotherapy: It is suitable for very small hemangioma, such as the size of a grain of rice, but not for large area, because the wound will easily cause infection and form a large scar after breaking. The disadvantage is that it is only suitable for superficial hemangiomas with a particularly small area. Systemic medication: Oral hormones can be used to promote the natural regression of hemangioma when surgical removal is not possible and laser treatment is not an option, but the efficiency is not high. Local drug injection: The ideal method is to inject sclerosing agent after microembolization to ensure that the drug stays in the tumor and does not spill over to the surrounding tissues. In addition to scarring, local deformities such as depressions may appear after several years, and plastic surgery is required. In principle, this method is suitable for people after puberty, and it has minimal indications in pediatric hemangioma. Excessive radiation exposure can cause stagnation or retardation of the tissues or organs that were irradiated during the development of the body in adolescence, resulting in serious deformities and endless consequences. New immunomodulators, etc., can enhance the immune function of the body to promote the natural regression of the tumor. In conclusion, the treatment of hemangioma is a very complicated task. In addition to the therapeutic effect at that time, we should also consider the long-term efficacy and the impact on the development of the body, so we should first choose those methods that are not harmful to the body and also take into account the treatment methods that have no or very few complications. Oral hormone therapy or laser control of its spread and growth, should be very careful to choose the right drug injection therapy, because it will leave scars and late local depression; as a last resort, please do not isotope (radiation) paste treatment, radiation therapy is far-reaching, it causes harm and deformity until many years later to show! In addition this work is also a dilemma, we all hope that it will naturally fade, but we can not determine who will naturally fade, because there is a part that does not disappear permanently, more difficult is in this waiting process will cause the loss of some tissue and organ function, for the later treatment to cause more difficulties, so should be early treatment or under the guidance of the doctor for observation.