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The fate of long-standing port-wine stain and its surgical management

Authors
 Kwan Chul Tark ; Dae Hyun Lew ; Dong Won Lee 
Citation
 Plastic and Reconstructive Surgery, Vol.127(2) : 784~791, 2011 
Journal Title
 Plastic and Reconstructive Surgery 
ISSN
 0032-1052 
Issue Date
2011
Abstract
BACKGROUND: A port-wine stain begins with thin macular lesions and eventually becomes hypertrophic and forms nodules. Although laser therapy for port-wine stain is a safe treatment modality that has been well-established, the long-standing port-wine stain has a tendency to respond less well to laser treatment. The authors performed total surgical resections of long-standing port-wine stain in the facial region, and attempted to clarify the histomorphologic changes. METHODS: The records of 15 patients with long-standing port-wine stain were reviewed for nodules and associated characteristics. After removal of the vascular lesions, the affected area was reconstructed with a radial forearm free flap or a skin graft depending on cosmetic considerations. All specimens obtained from resection were stained with hematoxylin and eosin and Victoria blue for elastic fibers for histomorphologic analysis. After a mean follow-up period of 12 years, the outcomes of surgical management were assessed. RESULTS: The nodules developed in 13 patients, and the mean age for nodule onset was 30 years. Victoria blue staining of the nodular lesions showed an intermingling of thick-walled vessels with abundant elastic fibers and thin-walled vessels without elastic fibers, which are findings typical of arteriovenous malformations. After surgical management, most of the outcomes were satisfactory, without complications or recurrence at long-term follow-up. CONCLUSIONS: A long-standing nodular port-wine stain can convert to a high-flow malformation with an arterial component, and these lesions are different from early-stage port-wine stains. For the treatment of long-standing port-wine stain that is resistant to laser therapy, surgical methods will bring more satisfactory outcomes than traditional laser therapy.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/92637
DOI
10.1097/PRS.0b013e318200a9e7
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Plastic Surgery & Reconstructive Surgery
Yonsei Authors
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Link
 http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006534-201102000-00036&LSLINK=80&D=ovft
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