General Care for Ulceration in Hemangiomas

If necrotic material is present a hydrocolloid gel is used and the lesion is covered by a second, nonadherent dressing and is held in position by tubular gauze.

If bleeding is a problem, calcium alginate dressings are used.

If there is a cavity, the dressing is torn up into small strands that are used to pack the cavity; again a second, nonadherent dressing is used over this. If there is a significant cavity in an exudative lesion, hydrocolloid gel can be used to fill the cavity. Hydrocolloid gel is also useful for frequent application to an ulcerated surface such as the lower lip where dressings are impractical.

For ulcerated and painful hemangiomas, duoderm dressings can be used in order to reduce pain, and most ulcers close in 1 to 2 weeks. If small skin breakdown is present, cleansing and a topical antibiotic should be used. If obvious ulceration is present, saline-soaked dressings should be applied wet and removed dry, to debride the crust and eschar so as to hasten reepithelialization. For pain, lidocain jelly may be helpful.

References: Mulliken JB. Pediatric Dermatology 1997;14:57-83 / Rogers M. Pediatric Dermatology 1997;14:57-83 / Rothman KF. Pediatric Dermatology 1997;14:57-83


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