Cleaning and dressing ulcerated haemangiomas

This page explains how you can clean and dress an ulcerated haemangioma to promote healing and reduce pain. Brand names for certain dressings used at Great Ormond Street Hospital (GOSH) are mentioned on this page – this does not constitute endorsement by GOSH and alternative dressings will be available.

Important

Always have the dressing and cleaning solution prepared before removing the old dressing.

When removing a dressing, do not remove forcibly but soak off gradually.

If bleeding occurs at any time during a dressing change, apply pressure using a clean cloth for five minutes without looking and secure in place. If blood soaks through the cloth, do not remove but add another cloth on top. Do not replace dressing for 48 hours.

If at all concerned, take your child to the nearest Accident and Emergency (A&E) department.

Dressing an ulcerated haemangioma on a limb or body

1. Collect together all the equipment you will need:

  • Antimicrobial or antibiotic ointment.

  • Non-adherent silicone dressing of appropriate size – such as Mepitel® or Adaptic®Touch.

  • Alginate dressings or similar of appropriate size – such as Sorbsan®.

  • Soft sterile gauze.

  • Cotton bandages and adhesive tape – such as Mepitac®.

  • Plaster tape – such as Elastoplast®.

  • Cooled boiled water , saline solution or sterile water – do not use tap water.

  • Oil based cleansing solution to use as a soak, pour or bath as required – such as Dermol® 600.

  • Stretchy tubular bandage to secure dressing – such as Tubifast® – readymade vests and balaclavas are available.

2. Prepare the dressing by laying several pieces of gauze on a sterile surface – such as the inside of one of the dressings pack.

3. Put a few drops of sterile water on the alginate dressing.

4. Put the alginate dressing on top of the gauze.

5. Open the non-adherent silicone dressing and cut to size.

6. Remove the plastic covering on one side.

7. Apply a layer of ointment large enough to cover the ulceration directly to the surface of the dressing.

8. Remove the plastic covering on the other side and place dressing ointment side upwards on top of the alginate dressing.

9. You should now have three different dressings layered together with the ointment side ready to put directly on the ulcerated area.

10. Clean the ulcerated area with water or saline by pouring the solution slowly over the area.

11. Alternatively, fill a baby bath with warm water and add the oil based cleansing solution according to the instructions on the bottle.

12. Bathe your baby for 10 to 15 minutes allowing the dressing to soak off gently.

13. If the dressing is stuck, soak it off gently – do not pull it off.

14. When the dressing has been removed and the area has been soaked with the water, leave it to dry naturally – do not towel dry the ulcerated area

15. When the area is dry, apply the prepared dressing, making sure that the ointment is covering the ulceration.

16. Secure the dressing in place using the cotton bandage and adhesive tape. Use the tubular bandage and tape to keep the dressing secure.

Dressing an ulcerated haemangioma in the nappy area

1. Collect together all the equipment you will need:

  • Antimicrobial or antibiotic ointment.

  • Non-adherent silicone dressing of appropriate size – such as Mepitel® or Adaptic®Touch.

  • Alginate dressing – such as Sorbsan® - or similar of appropriate size.

  • Soft sterile gauze.

  • Cooled boiled water, saline solution or sterile water – do not use tap water – or saline solution.

  • Oil-based cleansing solution to use as a soak, pour or bath as required – such as Dermol® 600.

  • Moisturising ointment – such as Diprobase® ointment – petroleum jelly – such as Vaseline®.

2. Prepare the dressing by laying several pieces of gauze on a sterile surface – such as the inside of one of the dressings pack.

3. Put a few drops of sterile water on the alginate dressing.

4. Put the alginate dressing on top of the gauze.

5. Open the non-adherent silicone dressing and cut to size.

6. Remove the plastic covering on one side.

7. Apply a layer of ointment large enough to cover the ulceration directly to the surface of the dressing.

8. Remove the plastic covering on the other side and place dressing ointment side upwards on top of the alginate dressing.

9. You should now have three different dressings layered together with the ointment side ready to put directly on the ulcerated area.

10. Clean the ulcerated area with water or saline by pouring the solution slowly over the area.

11. Alternatively, fill a baby bath with warm water and add the oil-based cleansing solution according to the instructions on the bottle.

12. Bathe your baby for 10 to 15 minutes allowing the dressing to soak off gently.

13. If the dressing is stuck, soak it off gently – do not pull it off.

14. When the dressing has been removed and the area has been soaked with the water, leave it to dry naturally – do not towel dry the ulcerated area.

15. When the area is dry, apply the prepared dressing, making sure that the ointment is covering the ulceration.

16. Put on a nappy to keep the dressing in place.

You will need to repeat this dressing twice a day. At nappy changes, if dressing is soiled, repeat above instructions but use moisturising ointment or petroleum jelly instead of the antimicrobial or antibiotic ointment. 

Compiled by: 
The Birthmark Unit in collaboration with the Child and Family Information Group.
Last review date: 
October 2013
Ref: 
2013F0336

Disclaimer

Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals.