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ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2008, Number 2

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Cir Plast 2008; 18 (2)

Chronic lymphedema treatment with omentum free flap

Priego BR, Haddad TJL ,Silva AAI, Vecchyo CC

Language: Spanish
References: 31
Page: 62-67
PDF size: 158.36 Kb.


ABSTRACT

Lymphedema occurs in the upper and lower limbs. It is one of the major long-term complications of axillary and groin dissections. Current surgical techniques are of some benefit but also have disadvantages. No present surgical technique offers definite cure. The use of microsurgical transfer of the greater omentum in the treatment of chronic lymphedema was evaluated. A group of five patients with chronic lymphedema is reported. Each was treated with free omentum flap. The possible benefits of a free omentum flap with measurements of the circumference of the limb with lymphedema were evaluated. A reduction of circumference of the upper or lower limb with chronic lymphedema was found in all patients. The free greater omentum flap eases the absorption and transport of lymph fluids and results in lymphedema reduction in limb affected with chronic lymphedema. The free omentum flap can be considered as a safe and effective therapy for chronic lymphedema.


REFERENCES

  1. Timothy M. Staged skin and subcutaneous excision for lymphedema: A favorable report of long-term results. Plast Reconstr Surg 1998; 102: 1486.

  2. MacDonald J. Lymphedema, lipedema and the open wound. The role of compression therapy. Surg Clin N Am 2003; 83: 639.

  3. Tiwari A. Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Arch Surg 2003; 138: 152.

  4. Olszewski W. The enigma of lymphedema: A search for answers. Lymphology 1991; 24: 100.

  5. Isao K. Ultrastructural Observations of lymphatic vessels in lymphedema in human extremities. Plast Reconstr Surg 1996; 97: 397.

  6. Hugo N. Recent advances in the treatment of lymphedema. Surg Clin North Am 1971; 51: 171.

  7. Harris S. Clinical practice guidelines for the care and treatment of breast cancer. Lymphedema. Can Med Ass J 2001; 164: 23.

  8. Savage R. The surgical management of lymphedema. Surg Gynecol Obstet 1984; 159: 501.

  9. Goldsmith H. Omental transposition in primary lymphedema. Surg Gynecol Obstet 1967; 125: 607-610.

  10. Levinson K. Age of onset in hereditary lymphedema. J Ped 2003; 142: 704-708.

  11. Petrek J. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer 2001; 92: 1368.

  12. O’Brien M. Microsurgical transfer of the greater omentum in the treatment of canine obstructive lymphoedema. Br J Plast Surg 1990; 43: 13.

  13. Chávez, Haddad J. Sistematización del manejo pre, trans y postquirúrgico de pacientes microquirúrgicos. Cir Plast 1995; 5: 37.

  14. Topor B. Omental transposition for low pelvic anastomoses. Am J Surg 2001; 182: 460.

  15. Gregory D. The Charles procedure: Misquoted and misunderstood since 1950. Plast Reconstr Surg 1996; 98: 1258.

  16. Maloney C. Free omental tissue transfer for extremity coverage and revascularization. Plast Reconstr Surg 2003; 111: 1899.

  17. Goldsmith H. Relief of chronic lymphedema by omental transposition. Ann Surg 1967; 166: 573.

  18. Casten D. Omental transfer for revascularization of the extremities. Surg Gynecol Obstet 1971: 301.

  19. Alcocer A. La transposición del epiplón mayor en el linfedema secundario a insuficiencia venosa crónica. Arch Inst Cardiol Mex 1972; 42: 444.

  20. Consensus Document of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema. Lymphology 2003; 36: 84.

  21. Foldi E. The lymphedema: chaos: a lancet. Ann Plast Surg 1989; 22: 505.

  22. Morrel R. Breast cancer-related lymphedema. Mayo Clin Proc 2005; 80: 1480.

  23. Ozaslan C. Lymphedema after treatment of breast cancer. Am J Surg 2004; 187: 69.

  24. Armer J. Post-breast cancer lymphedema in aging women. J Georontol Nur 2005: 29.

  25. Summer S. An investigation of lymphatic function following free-tissue transfer. Plast Reconstr Surg 1997; 99: 730.

  26. Yuhei Y. Microsurgical lymphaticovenous implantation for the treatment of chronic lymphedema. Plast Reconstr Surg 1998; 101: 157.

  27. O’Brien B. Microlymphaticovenous anastomoses for obstructive lymphedema. Plast Reconstr Surg 1977; 60: 197.

  28. Baumeister R. Treatment of lymphedemas by microsurgical lymphatic grafting: What is proved? Plast Reconstr Surg 1990; 65: 64.

  29. Thompson N. Buried dermal flap operation for chronic lymphedema of the extremities. Plast Reconstr Surg 1970; 45: 541.

  30. Degni M. New technique for the subcutaneous drainage of peripheral lymphedema. Lymphology 1992; 25: 182.

  31. O’Brien M. Replantation and reconstructive microvascular surgery. Ann R Coll Surg Engl 1976; 58: 171.




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