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

To investigate the surgical treatment and curative effect of hemangioma and vascular malformation in body surface.

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).

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.

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.