Evidence-Based Outcomes
Key Points ▪ The surgical treatment of lymphedema has not been evaluated in randomized clinical trials; therefore, the level of current evidence does not justify the widespread adoption of surgery…
Microsurgical Procedures: Vascularized Lymph Node Transfer from the Supraclavicular Region
Key points ▪ Harvesting lymph nodes from the axillary or groin region may cause secondary lymphedema of the upper or lower extremity. ▪ The main advantage of supraclavicular nodes harvest…
Microsurgical Procedures: Vascularized Lymph Node Transfer from the Submental Region
Key Points ▪ Design the upper margin of the flap just below the lower border of the mandible to make the scar inconspicuous. ▪ Preoperative ultrasound is a valuable tool…
Microsurgical Procedures: Vascularized Lymph Node Transfer From the Groin
Key Points ▪ The vascularized lymph node flap transfer from the groin was first introduced by Clodius in 1982 in two clinical cases. ▪ Animal studies described the vascularized lymph…
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….
