Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Lymphatic Leaks of the Thigh and Inguinal Region: Combined Plastic Surgery Approaches for an Effective Treatment Algorithm

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. A Systematic Review and Meta-analysis of Functional Shoulder Impairment After Latissimus Dorsi Breast Reconstruction

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. The Impact of Breast Implant Location on the Risk of Capsular Contraction

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. The Versatile Extended Thoracodorsal Artery Perforator Flap for Breast Reconstruction

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Giant Congenital Melanocytic Nevus: Report From 30 Years of Experience in a Single Department

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Delayed Breast Implant Reconstruction: Is Radiation Therapy Associated With Capsular Contracture or Reoperations?

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Infective Native Aortic Aneurysms: Call for Consensus on Definition, Terminology, Diagnostic Criteria, and Reporting Standards

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • William Watfa
  • Corrado Campisi
  • Melissa Ryan
  • Maurice Matter
  • Stephane Cherix
  • Karl Sörelius
  • Wassim Raffoul
  • Pietro Giovanni di Summa
Vis graf over relationer

BACKGROUND: Surgical procedures interfering with the draining nodes in the inguinal region carry the intrinsic risk of lymphatic complications. Lesions of the inguinal lymphatic network can lead to lymphocele or lymphocutaneous fistulas and can eventually be associated to limb lymphedema with consequent high morbidity.

OBJECTIVES: This article describes a new surgical algorithm based on wound properties to properly address lymphatic complications of the inguinal area. Based on our experience, surgical solutions ranged from selective lymphatic vessel ligation to microsurgical lymphatic fistula treatment and free tissue transfer.

METHODS: Fourteen consecutive patients underwent surgery in our department following failed attempts to address persistent lymphatic leaks. Patient characteristics such as smoking, previous surgeries, comorbidities, and wound properties were considered. Identification of the leak was performed using blue patent dye and indocyanine green fluorescence. Surgical reconstruction occurred, according to our algorithm.

RESULTS: Lymphatic leaks were visualized in 11 of 14 patients. Direct closure of the wound after leak ligation could be performed in 4 of 14 patients. Multilymphatic into vein anastomosis was performed in 3 of 14 patients, and the remaining patients benefited from flap surgery based on the wound defects. All 14 patients had successful outcomes (100%) with early drain removal (average, 6 [SD, 6] days) and definitive wound healing 2 weeks postoperatively. After a mean follow-up of 12 (SD, 2.9) months, no clinical infection, lymphatic complication, or wound breakdown occurred. One patient had a partial recurrence that did not require surgical intervention.

CONCLUSIONS: A stepwise approach, combining lymphatic surgery principles and plastic surgery flap techniques, can lead to an effective treatment algorithm where surgical options are wound tailored to guarantee the best functional outcomes.

OriginalsprogEngelsk
TidsskriftAnnals of Plastic Surgery
Vol/bind85
Udgave nummer6
Sider (fra-til)661-667
Antal sider7
ISSN0148-7043
DOI
StatusUdgivet - dec. 2020

ID: 62409392