Fox Carly M, Johnson Bethan, Storey Kristen, Das Gupta Romi, Kimble Roy
The Royal Children's Hospital Vascular Anomalies Group, Department of Paediatrics and Child Health, Lady Cilento Children's Hospital, South Brisbane, QLD, 4101, Australia,
Pediatr Surg Int. 2015 Jul;31(7):653-8. doi: 10.1007/s00383-015-3716-x. Epub 2015 May 13.
Infantile haemangioma is a common benign tumour of infancy. Ulceration is the most common complication and is often painful and difficult to treat. Propranolol therapy is widely used to induce involution in rapidly growing or ulcerated lesions, or those in anatomically awkward locations. The ideal dressing regimen for these lesions would provide effective analgesia, act as a wound dressing, and aid involution of the primary lesion. To date, no ideal regimen has been established. Negative pressure wound therapy (NPWT) has been used in adult and paediatric populations to help improve wound healing in a variety of settings. It may provide a useful alternative to traditional dressing regimens in ulcerated infantile haemangioma.
Six consecutive patients with ulcerating infantile haemangioma presenting to the Royal Children's Hospital vascular anomalies clinic were included in the study. Each patient was treated with a combination of NPWT and propranolol. Outcomes including time to wound healing, perceived ease of dressing management, and analgesia were recorded.
Complete wound healing was obtained in all cases. Patient outcomes in terms of analgesia, comfort, and ease of wound dressing were improved following application of NPWT.
DISCUSSION/CONCLUSIONS: We propose that this regimen represents a novel therapy for management of ulcerated infantile haemangioma. Possible mechanisms for healing effect, and improved analgesia are discussed. Further investigation is required to determine if negative pressure wound therapy results in faster healing times compared to traditional dressing regimens.
婴儿血管瘤是婴儿期常见的良性肿瘤。溃疡是最常见的并发症，通常疼痛且难以治疗。普萘洛尔疗法广泛用于促使快速生长或溃疡的病变，或解剖位置尴尬的病变消退。针对这些病变的理想敷料方案应能提供有效的镇痛效果，起到伤口敷料的作用，并有助于原发性病变的消退。迄今为止，尚未确立理想的方案。负压伤口治疗（NPWT）已用于成人和儿童群体，以帮助在各种情况下改善伤口愈合。它可能为溃疡型婴儿血管瘤的传统敷料方案提供一种有用的替代方法。
该研究纳入了连续6例到皇家儿童医院血管异常门诊就诊的溃疡型婴儿血管瘤患者。每位患者均接受NPWT和普萘洛尔联合治疗。记录包括伤口愈合时间、敷料管理的难易程度和镇痛效果等结果。
所有病例均实现了伤口完全愈合。应用NPWT后，患者在镇痛、舒适度和伤口敷料的难易程度方面的结果均得到改善。
讨论/结论：我们认为该方案是治疗溃疡型婴儿血管瘤的一种新疗法。讨论了愈合效果及镇痛效果改善的可能机制。需要进一步研究以确定与传统敷料方案相比，负压伤口治疗是否能缩短愈合时间。
