Surgical intervention in haemangiomas of the head and neck Bradford Cannon closure: results reassessment

Background Haemangioma is the most common vascular anomaly that affects infants. Although it is self-regressing, it can block visual field and airway. It might also cause mutilation. In surgically indicated cases, the residual defect is often large enough to present as a true reconstructive problem. Aim The aim of this study is to evaluate the purse-string closure method for circular and ovoid defects after excision of haemangioma in the face and scalp. Patients and methods We operated 25 targeted lesions (25 patients) with head and neck infantile haemangiomas. Ten lesions were in the involution stage, eight lesions were still in the proliferation stage and seven lesions were ulcerated and/or bleeding. Results There were reductions in the defects' dimensions by 53.8% for the longest dimension, 75% for the shortest dimension and 88% of the defect surface area. The results were very encouraging in areas with mobile skin, but we discourage any use of this method in the areas around the mouth and the eyelid because of initial distortion of the treated areas. One scalp case developed infection and the purse string had to be removed. The number of lesions in the scalp was markedly lower than the least number to enable a statistical analysis. Conclusion The purse-string closure (Bradford Cannon closure) is a powerful tool for the closure of skin defects after haemangioma excision in the face. It should be considered a first option whenever it does not distort a vital structure such as the mouth and the eyelids. For the scalp, the value of this technique needs further study considering that there are other good options as alternatives for this technique, particularly for the scalp.