Infantile haemangiomas are embryonal tumours and represent the most common tumour of infancy, with an estimated incidence 4-5%. There is well-described natural history, usually becoming apparent in the first few weeks of life and proliferating rapidly in the first few weeks of life with 80% reaching their maximal size by five months of age. This is followed by involution without scarring. There is however a subset that have severe morbidities such as pain, bleeding, scarring and psychosocial issues. Currently treatment is medical with Propanolol and intervention with LASER or surgical excision. There is paucity of data reviewing the predictive risk factors associated with a need for surgery. This is a good retrospective review of a single surgeon’s series of 112 patients from 2004 to 2011. Of the 112 patients 97 underwent one procedure, 14 patients two, and one patient three procedures. This is a good look at the surgical demographics of this cohort but it is a selected group, and many lesions may not have been referred if intervention was not required. It is also a small series of an individual surgeon and the authors accept both these limitations. The majority were also treated prior to the widespread use of Propanolol. This paper suggests there will always be a role for the surgeon and this study may be used as a comparison with a series of patients undergoing treatment with oral Propranolol.
Surgical indications for infantile haemangiomas
Reviewed by Sunil Kumar Bhatia
A retrospective study to classify surgical indications for infantile haemangiomas.
