When it comes to attempting to predict a post-treatment expected sequence of events for vascular abnormalities it will obviously depend on the treatment (if any) involved.
Basically, we describe three main modalities of treatment of vascular abnormalities and so will outline some timelines based on these approaches.
Watch and wait: this is self-explanatory. No active treatment is planned and in the short, medium and long term the condition will either regress, stay the same or get bigger. Generally, haemangioma will be managed this way with the option of a medical intervention with propranolol if they do not improve in the medium term. If medical intervention is used, regression is noticed within 7 to 14 days.
- short term: this can be quite painful and the impact of the sclerosing solution may not be immediately obvious;
- medium term: over a period of 3 to 4 weeks a gradual shrinking and shrivelling of the lesion can be seen. The injection may be repeated;
- long term: while substantial shrinkage of large cystic malformations will usually occur, the epithelial remnants of the original lesion remain and are not usually excised (it being much more difficult to do so after sclerotherapy than before fibrosis is induced).
Laser photocoagulation is a process which demands repeated application and is also very dependent on the type of laser and technique used. We would advise individual advice from your treating clinician is sought.
Surgical excision is the other modality of treatment and is a bit more predictable for the purpose of anticipating post-treatment sequalae.
- short term: several nights in hospital are usual as there is always a risk of postoperative bleeding and these operations can be extremely complex. Drains are used for any excisions, followed by conventional wound closure and are removed before a patient goes home. Open wounds, for example after excision of microcystic lymphangioma of the tongue are often painful and risk post-operative wound infection;
- medium term: a 10 day progressive recovery period is normal with sutures or staples being removed around day 6 or 7 for skin closures. Discomfort usually settles quickly unless secondary infection develops. If this happens (feels to be getting better then suddenly feels worse or more painful) return to your treating clinician as secondary infection is the most likely cause;
- long term: completely excised lesions, for example macrocystic lymphangioma should cause no long-term issues microcystic lesions are far more difficult to completely excise without causing undue and unnecessary damage to vital surrounding tissues and do commonly recur but usually to a lesser extent than the original problem.