title: Surgical treatment of infantile hemangioma in a multidisciplinary vascular anomalies clinic.
abstract: OBJECTIVE
  (1) Discuss indications for surgical treatment of infantile hemangioma (IH); (2) describe outcomes, management of complications and long term surveillance of surgically treated IH.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  The charts of children seen in a dedicated vascular anomalies center at a tertiary pediatric hospital were reviewed.
  
  
  RESULTS
  Out of 1012 patients diagnosed with IH over 27 months, 92 patients, predominantly caucasian female, with an average age of 36 months, underwent surgery for 94 lesions. Head and neck lesions accounted for 67% of the population and 51 lesions were located on the face. Surgical indications included bleeding, functional impairment, ulceration and cosmetic disfigurement. Mean surface area was 7.75 cm². Although lesions requiring additional procedures were larger (median 5.5 cm²) than single-stage excisions, this difference was not statistically significant (P=0.09). Head and neck lesions were more likely to require multiple modality treatment (P=0.003). There was no identified objective criteria to predict head and neck lesions that are more likely to be associated post-operative complications.
  
  
  CONCLUSIONS
  Most IH do not require treatment. The majority of infantile hemangioma occurred on the head and neck. When significant functional impairment, ulceration, bleeding, cosmetic deformity is encountered or anticipated, surgical therapy can be performed at any clinical phase with few complications and favorable outcomes.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin and Affiliated Hospitals, Milwaukee, WI, USA.
authors.forename: Opeyemi O
authors.initials: OO
authors.lastname: Daramola
authors.forename: Robert H
authors.initials: RH
authors.lastname: Chun
authors.forename: John J
authors.initials: JJ
authors.lastname: Nash
authors.forename: Beth A
authors.initials: BA
authors.lastname: Drolet
authors.forename: Paula E
authors.initials: PE
authors.lastname: North
authors.forename: John N
authors.initials: JN
authors.lastname: Jensen
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kerschner
mesh_terms: D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000601:surgery*; D006391:Hemangioma / Q000175:diagnosis / Q000601:surgery*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome