Vascular lesions are group of blood vessels disorder that can be congenital (present at birth but may appear after birth) or acquired. They may be cutaneous or in organs. Plastic surgeons deal skin vascular lesions.
Skin vascular lesions can be of capillary, arterial, venous, lymphatic or combined origin. Patients mostly have cosmetic issues. They may present with complications like ulceration, pain, bleeding, discharge, visible disfigurement or obstruction of vision and ear canal.
a) Surgery
Surgical excision is done under general anesthesia to either remove the primary lesion or to get rid of residual scars after other treatments.
b) Injection
I. Steroids steroid (triamcinolone) are injected in the lesion by small
needles. Multiple sessions may be needed at one month interval.
II. 3 % Sodium tetradecyl sulphate is a sclerosing agent.it is injected in
Large deep Vascular malformations
III. Ethanol (alcohol) can be injected as sclerosing agent into the lesion to
reduce the size of lesion
IV. Bleomycin is an antibiotic that may be injected into certain vascular
malformations to make them shrink.
V. Others (doxycycline, OK-432.)
c) Laser
Pulse dye laser, ND-YAG and Argon laser is effective in treatment of small
cutaneous vascular lesions. Light is absorbed by red hemoglobin and destroy the blood vessels in the lesion. It has minimal damage to the surrounding tissues.
d) Cautery
Electrocautery can be used to treat superficial vascular lesions on face. Its less
invasive and used in small lesions.
1.What causes a vascular lesion?
1.Some lesions are genetical while others have unknown cause.
2. Does laser is the treatment of choice for all vascular lesions?
2.Laser addresses only small cutaneous lesions (mostly capillary origin). It can
also reduces residual lesions after surgery. Large high flow lesions cannot be
treated with laser alone.
3.Are there any chances of recurring of the lesion after treatment?
Outcome depends on the location and size of the fistula and status of surrounding tissues. Although most of the fistula closes after the surgery, some may recur and requires further surgery.
It usually takes less time than the original hypospadias repair and completes in less than an hour.
The surgery is performed under general anaesthesia and as a day care procedure. Patient can go home the same day after recovery from anaesthesia.
The most common complication is recurrence of the defect. Others complications include infection, difficulty in urination and stricture formation
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