Individualized Surgical Management of Refractory Port-Wine Stains in the Scalp and Face: A Single-Center Retrospective Study and a Discussion of Surgical Strategies

Qian Wang; Chen Yong; Min Wang; Lei Cui; Si-Ming Yuan

doi:10.2147/CCID.S370491

Individualized Surgical Management of Refractory Port-Wine Stains in the Scalp and Face: A Single-Center Retrospective Study and a Discussion of Surgical Strategies

Clin Cosmet Investig Dermatol. 2022 Aug 3:15:1527-1535. doi: 10.2147/CCID.S370491. eCollection 2022.

Authors

Qian Wang¹, Chen Yong¹, Min Wang¹, Lei Cui¹, Si-Ming Yuan^{1

2}

Affiliations

¹ Department of Plastic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People's Republic of China.
² Department of Plastic Surgery, Jinling Hospital, Nanjing School of Clinical Medicine, Southern Medical University, Nanjing, 210002, People's Republic of China.

Abstract

Objective: Refractory port-wine stain (PWS) usually contains hypertrophic, nodular lesions or severe scars due to improper treatment, making surgical treatment a necessity. This study aims to introduce our experiences in surgical management of refractory PWSs in the scalp and face.

Methods: From January of 2013 to September of 2018, 25 patients with refractory PWSs in the scalp and face received surgeries in our department. Clinical manifestation of the disease, the surgical procedures and postoperative complications were reviewed. A Visual Analog Scale (VAS) was applied to evaluate the outcomes.

Results: In this study, surgical procedures included serial resection (4 cases), complete resection followed by local flap transplantation (6 cases) or skin grafting (7 cases), and two-staged surgeries using expanded flaps (5 cases) or expanded prefabricated flap (3 cases). All the skin grafts and flaps survived well. Follow-up evaluation with VAS showed that most patients were satisfied with the surgery.

Conclusion: The surgical procedures should depend on the site, area and type of the lesions and patients' personal requirement. Individualized surgical treatment of refractory PWSs achieved satisfactory results in re-establishing symmetric facial contour and improving the overall appearance.

Keywords: port-wine stain; scalp and face; surgery strategy.

Grants and funding

This study was supported by the National Natural Science Foundation of China (No. 81272989, awarded to Dr. Si-Ming Yuan), “333 Project” of Jiangsu Province, China (No. BRA2020416, awarded to Dr. Si-Ming Yuan), and the Foundation for Key Medical Specialty of Nanjing (SZDZK202001, awarded to Dr. Si-Ming Yuan).