title: Assessment of the role of LASER-Doppler in the treatment of port-wine stains in infants.
abstract: BACKGROUND
  Port-wine stains (PWS) are malformations of capillaries in 0.3% of newborn children. The treatment of choice is by pulsed dye LASER (PDL), and requires several sessions. The efficacy of this treatment is at present evaluated on the basis of clinical inspection and of digital photographs taken throughout the treatment. LASER-Doppler imaging (LDI) is a noninvasive method of imaging the perfusion of the tissues by the microcirculatory system (capillaries). The aim of this paper is to demonstrate that LDI allows a quantitative, numerical evaluation of the efficacy of the PDL treatment of PWS.
  
  
  METHODS
  The PDL sessions were organized according to the usual scheme, every other month, from September 1, 2012, to September 30, 2013. LDI imaging was performed at the start and at the conclusion of the PDL treatment, and simultaneously on healthy skin in order to obtain reference values. The results evidenced by LDI were analyzed according to the "Wilcoxon signed-rank" test before and after each session, and in the intervals between the three PDL treatment sessions.
  
  
  RESULTS
  Our prospective study is based on 20 new children. On average, the vascularization of the PWS was reduced by 56% after three laser sessions. Compared with healthy skin, initial vascularization of PWS was 62% higher than that of healthy skin at the start of treatment, and 6% higher after three sessions. During the 2 months between two sessions, vascularization of the capillary network increased by 27%.
  
  
  CONCLUSIONS
  This study shows that LDI can demonstrate and measure the efficacy of PDL treatment of PWS in children. The figures obtained when measuring the results by LDI corroborate the clinical assessments and may allow us to refine, and perhaps even modify, our present use of PDL and thus improve the efficacy of the treatment.
authors.affiliation: Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland.
authors.forename: Tessa
authors.initials: T
authors.lastname: Mermod
authors.affiliation: Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland.
authors.forename: Oumama
authors.initials: O
authors.lastname: El Ezzi
authors.affiliation: Department of Plastic and Hand surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland.
authors.forename: Wassim
authors.initials: W
authors.lastname: Raffoul
authors.affiliation: Department of Plastic and Hand surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland.
authors.forename: Paolo
authors.initials: P
authors.lastname: Erba
authors.affiliation: Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland. Electronic address: anthony.debuys-roessingh@chuv.ch.
authors.forename: Anthony
authors.initials: A
authors.lastname: de Buys Roessingh
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D017078:Laser-Doppler Flowmetry; D054025:Lasers, Dye / Q000627:therapeutic use*; D008297:Male; D008833:Microcirculation; D019339:Port-Wine Stain / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Angioma; Doppler; LASER