Combined treatment with urea injection and surgical correction for venous malformations of the hand

Abstract

Objective To investigate the safety and efficacy of urea injection combined with surgery for treatment of venous malformation of the hand. Methods A retrospective analysis was conducted of 46 cases of venous malformations in the hand. Preoperatively multipoint and multilayer injection of urea solution with a mass fraction of 40% was administered daily to the pathologic sites. The volume of the injection is 2 to 5 ml. The duration of the injection was 7 days followed by one day of withdrawal before the surgery. Postoperatively remission of the tumors was evaluated and the patients were followed up to assess the recurrence rate. Results Thirty-nine cases had one stage surgical resection with no recurrences. A second surgery was required in 5 cases to completely remove the malformations. In 2 cases where the lesions involved the entire hand, only lesions with obvious pain were surgically resected, supplemented by injections of sclerotic agents every 3 months that led to control of tumor growth, pain relief, and alleviation of the symptoms. Conclusion Urea injection is an effective adjunct to surgical resection. It controls tumor growth, hardens the tumors and provides clear demarcation of the tumors all of which can reduce intraoperative bleeding and facilitate complete removal of the tumors. It leads to early pain relief and restoration of normal hand function. It is an effective method for treatment of venous malformations of the hand. Key words: Urea; Surgical procedures, operative; Hand; Vein malformations