Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China.
BMC Pediatr. 2024 May 28;24(1):368. doi: 10.1186/s12887-024-04838-4.
Lip infantile hemangiomas tend to show less volumetric regression and are more susceptible to visible sequelae in the involuted stage. Some of them still require surgical management after propranolol therapy. This study aimed to evaluate the efficacy and safety of the Stepwise, Multi-Incisional, and Single-Stage (SMISS) approach applied to lip reduction for those with involuted lip hemangiomas.
A retrospective review was performed to evaluate patients with lip hemangioma who received previous propranolol treatment and underwent the aforementioned procedure. Demographic characteristics, lesion morphology, and medical history were reviewed. The Visual Analog Scale was applied to assess the postoperative appearance. Complications within 12 months postoperatively were recorded.
A total of 18 patients with lip hemangioma were eligible. All patients received oral propranolol therapy before surgery, with treatment duration ranging from 6.0 to 23.0 months. Their age at surgery ranged from 2.5 to 9.0 years. The median Visual Analog Scale scores were 8.0, ranging from 4.0 to 10.0. No severe complications were reported.
This modified technique based on the SMISS approach has proven reliable and effective in improving the aesthetic outcome for involuted lip infantile hemangiomas. Practical surgical techniques still play an important part in the propranolol era.
唇部婴幼儿血管瘤往往表现为体积消退较少，在消退期更容易出现明显的后遗症。其中一些在接受普萘洛尔治疗后仍需要手术治疗。本研究旨在评估逐步、多切口、单阶段（SMISS）方法在治疗消退期唇部血管瘤中的疗效和安全性。
回顾性分析了接受过普萘洛尔治疗并接受上述手术的唇部血管瘤患者。回顾了患者的人口统计学特征、病变形态和病史。采用视觉模拟评分法评估术后外观。记录术后 12 个月内的并发症。
共有 18 例唇部血管瘤患者符合条件。所有患者在手术前均接受过口服普萘洛尔治疗，治疗时间为 6.0 至 23.0 个月。手术时年龄为 2.5 至 9.0 岁。中位数视觉模拟评分（VAS）为 8.0，范围为 4.0 至 10.0。未报告严重并发症。
基于 SMISS 方法的这种改良技术已被证明可有效改善消退期唇部婴幼儿血管瘤的美学效果。在普萘洛尔时代，实用的手术技术仍然起着重要作用。
