INJECTION OF BOILING HYPERTONIC SALINE IN THE TREATMENT OF CUTANEOUS HAEMANGIOMA

Zuhair F Fathallah

doi:10.33762/bsurg.2016.116610

Abstract

This study deals with a new way for the treatment of cutaneous haemangiomas in children and adults by using a boiling hypertonic saline, the material used is safe and nontoxic even if absorbed. A total of 309 patients with 354 haemangiomas were studied. The sample consisted of 233 females and 76 males ranging in age from 2 months to 50 years. Patients were divided into three groups; Group I: observation, Group II: excision and reconstruction, Group III: injection & excision. Each patient in group III received 2-4 shots of boiling saline intra-lesional at an interval of 3-4 weeks, to allow time for the post injection swelling to subside and fibrous tissue to mature. The female to male ratio was 3.1:1. The lesion appears within the first weeks after birth in 189 children (61.3%). Among the 309 patients, 288 (81.4%) haemangiomas were located on the head and neck, 39 (11%) on the trunk, 25 (7%) on the extremities, and 2 (0.6) in the perineal area. The three groups are as follows: group I: observation; 161 patients (52%). group II: excision and reconstruction. 42 patients (13.7); group III: injection & excision, 106 patients (34.3%). The presenting symptoms at consultation were parents worry 200 patients (64%), obstruction of orifices 38 (12.3%), ulceration 32 (10.6 percent), bleeding 26 (8.2%), infection 10(3.2%), and pain 3 (0.8percent). The complications after treatment of the 106 patients were; bleeding 3 patients (2.3%), infection 7 (6.8%), skin necrosis 20 (19.3%); the remaining patients 76 (71.6%) tolerate the injection easily and show no effect. The evaluation of patients treated with boiling saline sclerotherapy is based on improvement of volume, color, and texture as follow, poor 10 (9.1%); good 54 (51.1%); and excellent 42 (39.8%). In conclusion, treatment of cutaneous Haemangioma is indicated when there is no sign of involution. Injection sclerotherapy with boiling saline proved to be safe, nontoxic, cheap and effective.

Highlights

Haemangiomas are the most common benign vascular tumors of infancy, that affect roughly as many as 10% of infants[1]
On rare occasion a cutaneous Haemangiomas may associated with underlying congenital anomalies[2,4]
The study was conducted during the period January 2000 till December 2009 with the approval of the scientific committee of the Dept. of Surgery/Basrah Medial College. It is a retrospective study of 309 patients with cutaneous haemangiomas referred to the out patients department (OPD) of Plastic Surgery unit of Basrah Teaching Hospital

Summary

Introduction

Haemangiomas are the most common benign vascular tumors of infancy, that affect roughly as many as 10% of infants[1]. They are most commonly presented shortly after birth, it has a period of rapid growth during early infancy followed by gradual involution[2,3]. The majority of these tumors are medically insignificant, but it may intrude on vital structures, ulcerate, bleed, infected or cause significant structural abnormalities. Most superficial haemangiomas range in size from a few millimeters to several centimeters in diameter, presented as a white or pink macule, a port wine stain like lesion of the skin[6], or it may show itself as erythematous patch, blanched spot or localized telangiectasia within

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Conclusion