Overview of Surgical Techniques
Key Points ▪ Reductive procedures (direct excision with skin grafting or liposuction) alone or as an adjunct are effective in gross reduction of volume; however they carry significant morbidity. ▪…
Recipient Site Selection in Vascularized Lymph Node Flap Transfer
Key Points ▪ A vascularized lymph node flap can be transferred to virtually any location on the extremities, but is usually transferred to the axilla, elbow, wrist, groin, knee, or…
Microsurgical Procedures: Combined Microvascular Breast Reconstruction and Lymph Node Transfer
Key Points ▪ Lymph node transfer is still considered as experimental surgery. ▪ Lymph node transfer can be easily combined with routine microvascular breast reconstruction. ▪ Lymph node flap contains…
Excisional Procedures and Their Combinations with Lymphatic Microsurgery
Key Points ▪ Treatment of advanced lymphedema remains a challenge in reconstructive surgery. Surgical management with excisional procedures is indicated in select patients when conservative measures have failed. ▪ Based…
Excisional Procedures: Liposuction
Key Points ▪ If there is significant pitting (> 8–10 mm in depth) of the lymphedematous limb, conservative treatment (combined physiotherapy) is indicated to remove the lymph and transfer the…
Lymphedema Risk Reduction and Management
Key Points ▪ Cancer survivors who have had treatment affecting the lymph drainage system have a lifelong risk of developing lymphedema. ▪ Lymphedema management includes risk-reduction education and lymphedema treatment….
Physiologic Principles of Lymphatic Microsurgery
Key Points ▪ Following injury to the lymphatic system, development of lymphedema involves a predictable progression of disease represented by histological, architectural, and pressure gradient changes within the involved area….
Laboratory Study of Lymphedema
Key Points ▪ Lymphangiogenesis occurs in four distinct regulatory phases: lymphatic competence, lymphatic commitment, lymphatic speciation and lymphatic maturation. ▪ Vascular endothelial growth factor-C/vascular endothelial growth factor receptor-3 signaling is…
Clinical Evaluation of Lymphedema
Key Points ▪ Lymphedema severity may require different treatment approaches. The indications for referral to conservative therapy are different from those for referral for surgery. ▪ Knowing the extent to…
Definition, Incidence and Pathophysiology of Lymphedema
Key Points ▪ Lymphedema occurs as a result of congenital abnormalities (primary lymphedema), injury or infection (secondary lymphedema) of the lymphatic system. ▪ Most common cause in developed countries is…
