Diagnosis and Management of Infantile Hemangioma

Table D. Summary of evidence in studies addressing effectiveness of surgical interventions (continued)
Intervention
Type/Number of
Studies (Total N
Participants)
Key Outcome(s)
Strength of
Evidence
(SOE) Grade
Lasers
(continued)
PDL
RCT: 2 (173)
Cohort studies: 2 (73)
Findings
Pigmentation changes Moderate Hypo- or hyper-pigmentation consistently reported, with
hypopigmentation reported more frequently.
Moderate SOE for association of PDL with skin pigmentation
complications based on relatively few participants in studies.
Case series: 5 (1017)
PDL
RCT: 1 (121)
PDL
RCT: 1 (121)
PDL
Cohort studies: 1 (50)
Case series: 3 (769)
Nd: YAG
Cohort studies: 1 (50)
Nd: YAG
Cohort studies: 3
(386)
Bleeding Low No significant difference in bleeding between short pulse PDL and
observation groups.
Low SOE for association of bleeding with PDL based on one study with
low limitations, unknown consistency, and imprecision.
Pain Insufficient 13% of parents reported pain for their children after PDL.
Insufficient SOE for pain following PDL given low numbers of outcome.
Pain is also difficult to assess in infant population.
Scarring Insufficient 1/25 children receiving PDL in one study and 7/769 children in case
series had scarring.
Insufficient SOE due to few instances of the outcome reported in
studies.
Pigmentation changes Insufficient 2/25 children receiving Nd:YAG in one study had scarring.
Insufficient SOE due to few instances of the outcome reported in
studies.
Scarring Low Most studies reported scarring in ≤5% of children in 6 studies.
Low SOE for association of scarring with Nd:YAG treatment due to few
occurrences of the outcome reported.
Case series: 3 (954)
Nd: YAG
Case series: 2 (794)
Bleeding Insufficient Bleeding noted in 13/794 children in 2 studies.
Insufficient SOE due to few instances of the outcome reported in
studies.
ES-25