Infantile haemangiomas (IHs) are embryonic tumours and represent the most common tumour of infancy, with an estimated incidence of 4-5%. There is a well described natural history, usually becoming apparent in the first few weeks of life and proliferating rapidly, with 80% reaching their maximal size by five months of age. This is followed by involution without scarring. There is, however, a subset of IHs that have severe complications or severe morbidities such as pain, bleeding, scarring and psychosocial issues. Currently treatment is medical with oral propanolol and interventional with laser or surgical with 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 August 2004 to August 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 this is a selected group as 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 in the pre-propranolol era. This paper suggests there will always be a role for the surgeon in these lesions and this study may be used as a comparison with a series of patients undergoing treatment with oral propranolol.

A retrospective study to classify surgical indications for infantile haemangiomas.
Lee AHY, Hardy KL, Goltsman D, et al.
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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