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Vascularized Lymph Node Transfer for the Treatment of Posttraumatic Lower Extremity Lymphedema: A Preliminary Report.

Pedro CiudadMaria T HuayllaniAntonio Jorge ForteDaniel BoczarFrancisco R AvilaJoseph M EscandónOscar J ManriqueHung-Chi Chen
Published in: Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India (2022)
Background  Posttraumatic lymphedema develops more frequently than expected and reports on its management are scarce in the literature. We aimed to report the clinical outcomes of a case series of posttraumatic lymphedema patients treated with different vascularized lymph node transfers (VLNTs). Patients and Methods  Five patients with secondary posttraumatic lower limb lymphedema treated with VLNT were included in this report. The groin-VLNT ( n  = 1), supraclavicular-VLNT ( n  = 2), and gastroepiploic-VLNT ( n  = 2) were implemented. The average flap area was 69.8 cm 2 . Patients underwent postoperative complex decompressive therapy for an average of 10.0 months. Results  The average mean circumference reduction rate was 24.4% (range, 10.2-37.6%). Postsurgical reduction in the number of infection episodes per year was observed in all patients. The mean follow-up was 34.2 months. Conclusions  VLNT is a promising surgical treatment for posttraumatic lymphedema patients. In our report, VLNT has demonstrated to reduce the volume and number of infections per year in posttraumatic lymphedema.
Keyphrases
  • end stage renal disease
  • lymph node
  • newly diagnosed
  • ejection fraction
  • chronic kidney disease
  • systematic review
  • body mass index
  • patient reported outcomes
  • neoadjuvant chemotherapy
  • smoking cessation