Investigate the impact of different sclerosing agents on the complications in the sclerotherapy of cutaneous soft tissue venous malformations
Objective To analyze and compare the related complications after sclerotherapy of cutaneous soft tissue venous mal-formations by different sclerosing agents.And to explore preventive measures for complications,as well as key points in observation and treatment.Methods The cases with venous malformation in cutaneous soft tissue treated in our department from January 2011 to Decem-ber 2023 were reviewed.All patients had complete follow-up data.According to the type of sclerosing agents,they were divided into the anhydrous ethanol group,foam sclerosing agent group,Pingyangmycin group,and combined treatment group with anhydrous ethanol and foam sclerosing agents.The complications,treatment measures and results were analyzed.Results A total of 301 patients were included and 636 treatments were completed.In the anhydrous ethanol group,215 cases were treated with sclerotherapy 454 times.In the foam sclerosing agents group,41 cases were treated 80 times.Twelve cases in the pingyangmycin group were treated 23 times.In the combined treatment group,33 cases were treated 79 times.A total of 358 complications were observed,with an incidence of 56.29％,including.(1)Pain and swelling 152 times.(2)Pigmentation 17 times.(3)Superficial vein embolization 42 times.(4)Skin mucosa ulcer necrosis 25 times.(5)Muscle/tendon contracture 7 times.(6)Nerve injury caused numbness 13 times.(7)Gastrointestinal reaction:1 case.(8)Nin-ty-nine times of anxiety caused by psychological factors.Most of the complications recovered after conservative treatment,and only 3 cases required surgical treatment.The incidences of complications in the anhydrous ethanol group,foam sclerosing agents group,pingyangmycin group and combined treatment group were 59.03％、62.50％、43.48％and 37.97％respectively.There were no serious systemic complica-tions such as hypersensitivity,ectopic embolism,liver and kidney injury and pulmonary fibrosis.Conclusion Anhydrous ethanol,polydo-caol/lauryl alcohol foam and pingyangmycin alone or in combination with sclerotherapy have good efficacy and safety.The combined treat-ment has a lower complication rate.The selection of the appropriate sclerosing agent,precise positioning,strict control of injection speed and dosage,and timely handling of postoperative abnormal reactions can help in the prevention and treatment of complications.
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