A technique of combined laser photodestruction - for radical treatment of pyogenic granuloma in children

Introduction. Pyogenic granuloma is a benign vascular tumor-like formation on the skin having inflammatory etiology. It is often seen in childhood; its complications in the form of ulcerations and bleedings are met in about 7.5% of cases.

Material and methods. Over the past two years, 164 patients were operated on for pyogenic granulomas at the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST) in Moscow. 120 of them had bleedings in the anamnesis. Before surgery, all patients had ultrasound examination with color Doppler mapping (CDM) of their vascular formation. 137 children had planned surgeries under local anesthesia in an outpatient unit. 27 patients had bleeding from their pyogenic granulomas on the admission. On reaching hemostasis after conservative treatment, 21 of them had delayed surgeries; 6 children with severe bleeding, in who conservative treatment was ineffective, were operated urgently. All delayed surgeries were made under local anesthesia in an outpatient surgical room; urgent surgeries were performed under general anesthesia in a hospital surgical room.

A technique of combined laser photodestruction was applied in all 164 patients with pyogenic granulomas (invention priority dated May 11, 2022). Laser surgical device “IRE-Polyus” (Russia) with a wavelength of 0.97 urn, was used for this.

Results. Postoperative period in all patients was uneventful; complete healing of wound defect was seen on day 10±2. No recurrence or residual elements of the vascular formation were observed. After surgical treatment, good clinical and esthetic results were obtained in all 164 patients.

Conclusion. To prevent complications of pyogenic granulomas in children, surgical treatment with a technique of combined laser photodestruction is recommended. Moreover, the discussed technique has been developed with considerations of structural features of pyogenic granulomas. A technique of combined laser photodestruction allows to radically remove pathological tissues of pyogenic granuloma both in inpatient and outpatient settings and guarantees reliable hemostasis, thus providing good clinical and esthetic outcomes in pediatric patients.