Is it better to reduce the intervals between pulsed dye laser treatments for port wine stains in children? Laser Doppler Imaging based study

Oumama El Ezzi; Mermod Tessa; Ballabeni Pierluigi; Anthony S de Buys Roessingh

doi:10.1016/j.jpedsurg.2019.12.007

Is it better to reduce the intervals between pulsed dye laser treatments for port wine stains in children? Laser Doppler Imaging based study

J Pediatr Surg. 2020 Nov;55(11):2459-2465. doi: 10.1016/j.jpedsurg.2019.12.007. Epub 2019 Dec 28.

Authors

Oumama El Ezzi¹, Mermod Tessa², Ballabeni Pierluigi³, Anthony S de Buys Roessingh⁴

Affiliations

¹ Service of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), CH-1011 Lausanne, Switzerland. Electronic address: oumama.el-ezzi@chuv.ch.
² Service of Plastic and Reconstructive Surgery, University Hospital Center of the Canton of Vaud (CHUV), CH-1011 Lausanne, Switzerland.
³ Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
⁴ Service of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), CH-1011 Lausanne, Switzerland.

PMID: 31948669
DOI: 10.1016/j.jpedsurg.2019.12.007

Abstract

Background: Pulsed Dye Laser (PDL) is the treatment of choice of Port Wine Stains (PWS). Laser Doppler Imaging (LDI) has been used to evaluate the effectiveness of this treatment. In a previous study, we demonstrated that LDI allows an objective evaluation. The purpose of this study is to investigate if reducing the delay between two laser sessions could improve the clinical outcome.

Method: This prospective study was conducted from September 2015 to November 2017. Three Laser sessions were performed every month in twenty patients with PWS. The PWS response was assessed by LDI after each session and at the end of the third one. The present study was compared to the first one.

Results: The LDI confirmed the efficacy of PDL treatment with an average blanching rate of 26.7 %. The response is statistically significant after each session. When we compare both studies, there is an average decrease in vascularization of 0.42 for the first study and 0.50 for the present one.

Conclusion: This study allows us to validate the use of LDI for the numerical evaluation of PDL effect on PWS in children. However, we cannot confirm that reducing the interval between laser sessions could improve therapeutic outcomes.

Levels of evidence: Treatment Study Level II (Prospective Comparative Study).

Keywords: Angioma; Capillary malformation; Laser; Laser Doppler Imaging; Port wine stains.

Publication types

Review

MeSH terms

Angiography
Child
Humans
Lasers, Dye* / therapeutic use
Port-Wine Stain* / surgery
Prospective Studies
Treatment Outcome