Introduction. Pyogenic granuloma (PG), a benign vascular tumor of the skin of inflammatory etiology, is often met in children. Complications of this pathology (ulceration and bleeding) are seen in 7.5% of cases. Material and methods. 67 patients were operated on for pyogenic granulomas. 22 patients had bleedings. Before surgery, all patients had sonography with color Doppler mapping of this vascular formation. 57 children had a planned surgery and were operated under topical anesthesia in the outpatient unit. 10 patients on admission had bleedings from pyogenic granulomas. After conservative arresting the bleeding, 7 patients out of these 10 had urgent surgery; in other three children with severe bleeding hemostasis was not achieved conservatively, and they were immediately operated on. All urgent surgical interventions were made under local anesthesia in an outpatient operating room. Patients with emergency cases, were younger than 3 y.o. They were operated in the operation room in the hospital under general anesthesia. Pyogenic granulomas in all 67 patients were removed by the technique of interstitial selective laser photodestruction, the prototype of which was “Method for treating cavernous forms of hemangiomas in children” developed and patented in CRIEPST. For this surgical intervention, two-wave laser surgical device “IRE-Polyus” (Russia), with wavelength of 0.97 mkm and 1.56 mkm was used. Results. Postoperative period in all patients was uneventful, with complete healing of wound defect in 10-12 days; no recurrences of vascular formation or its residual elements were observed in any case. All 67 patients had good clinical and aesthetic results after the applied surgical technique. Conclusion. To prevent complications in children with pyogenic granulomas, surgical treatment with the technique of interstitial selective laser photodestruction adapted for this pathology is recommended. The described interstitial selective laser photodestruction radically removes pathological tissues of pyogenic granulomas and ensures reliable hemostasis, what leads to good clinical and aesthetic results in treating the discussed group of patients both in inpatient and outpatient settings.

Capillary angiodysplasia of the skin presents by itself pathologically dilated capillaries located under the basal zone of the growth of the epidermis. There are many options for the correction of this vascular pathology of the skin, including general and local methods. In recent years, laser treatments for capillary angiodysplasia have become widespread. According to many authors, the most effective and promising method is laser photodestruction by radiation of the yellow-green spectral range. Unfortunately, the optimal ranges of the parameters of exposure to laser radiation in the treatment of specific forms of capillary angiodysplasia of the skin, taking into account nature and age characteristics of the skin in children, have not yet been determined.

Introduction. Hemangiomas in infants at their first weeks of life can quickly progress and lead not only to the disfigurement of appearance, but also to serious complications, like bleeding, ulceration, suppuration and other negative consequences. Purpose. To have good clinical and aesthetic results in children with cavernous hemangiomas using the technique of interstitial selective laser photodestruction. Material and methods. In 2016 - 2018, focal forms of hemangiomas were registered in 140 children aged 1 month-16 years who were consulted in the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma. The technique of interstitial selective laser photodestruction was selected for surgical treatment in all patients (RF Patent №2016110843 dated 04.09.2017). Two-wave laser surgical apparatus LSP IRE-Polyus (Russia) with wavelengths 0.97 μm and 1.56 μm was used. All 140 patients had ultrasound examination of their vascular formations and other preoperative procedures . The surgical intervention was performed in the hospital under general anesthesia. 131 of patients had planned operations and 9 of them had urgent operations because of hemangioma bleeding. Results. Long-term outcomes have shown that in 100% of cases we achieved good clinical result with no residual hemangioma elements; in the majority of cases (69%) the optimal aesthetic result was achieved; and in 31% of cases we had satisfactory outcomes by the criteria of aesthetic effectiveness. Conclusions. Interstitial selective laser photodestruction is the best option to radically treat focal forms of hemangiomas in children.

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