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LASER SURGERY FOR SKIN VASCULAR TUMORS IN INFANTS


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Abstract

In young children, benign vascular tumors (VT) are most often manifested as congenital hemangioma and infantile hemangioma. There are considered clinical variants, pathogenesis, evaluation of severity and approaches to assessing the effectiveness of laser surgical treatment for VT in infants. For the first time, there are presented numerical criteria for selecting the optimal laser system to provide the relevant photo-obstruction of the pathological vascular bed, reducing the risk for the development of side effects in the early and remote period after the laser radiation exposure. Comparison of the values of the coefficients of complete absorption of oxyhemoglobin and hemoglobin at different stages of vascular tumor development shows the optimal laser treatment of vascular tumors can be realized by the laser radiation with a wavelength of 578 nm, since it is absorbed to the maximum extent by the main vascular photothermophores - oxyhemoglobin and hemoglobin. Taking into account the features of the angioarchitecture of the pathological vascular bed of the papillary dermis, to prevent the occurrence of petechial hemorrhages (purpura) immediately after the procedure, laser irradiation should be carried out in a pulsed mode with a pulse duration of 15-20 ns. To prevent thermal damage to the reticular layer of the dermis, it is advisable to use a laser pen with a diameter of 0.6-1 mm. The choice of optimal conditions for radiation exposure ensures high efficiency of the laser treatment of vascular tumors, which have been becoming one of the most promising directions in modern hospital-replacing technologies in pediatric laser surgery.


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