Long-term functional outcomes upon application of split-thickness skin graft around major joints in HCC (Hung-Chi Chen)-modified Charles’ procedure for advanced lymphedema

Chen, Shih‐Heng; Yıldırım, Mehmet; Mousavi, Seyed Abolghasem; Chen, Hung-Chi

doi:10.1016/j.asjsur.2020.05.001

Cited by 5 publications

(5 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Charles procedure is usually reserved for severely deformed patients. Skin grafting for a large area with unsightly scars and a long recovery period is not uncommon [ 34 ]. Most importantly, these abovementioned procedures do not resolve the issue of obstructed lymphatic return.…”

Section: Discussionmentioning

confidence: 99%

Lower Limb Lymphedema Patients Can Still Benefit from Supermicrosurgical Lymphaticovenous Anastomosis (LVA) after Vascularized Lymph Node Flap Transfer (VLNT) as Delayed Lymphatic Reconstruction—A Retrospective Cohort Study

Yang

Hayashi

et al. 2021

JCM

View full text Add to dashboard Cite

Background: For lymphedema patients who received a vascularized lymph node flap transfer (VLNT) as their primary treatment, what are the treatment options when they seek further improvement? With recent publications supporting the use of lymphaticovenous anastomosis (LVA) for treating severe lymphedema, we examined whether LVA could benefit post-VLNT patients seeking further improvement. Methods: This retrospective cohort study enrolled eight lymphedema patients with nine lymphedematous limbs (one patient suffered from bilateral lower limb lymphedema) who had received VLNT as their primary surgery. Patients with previous LVA, liposuction, excisional therapy, or incomplete data were excluded. LVA was performed on nine lower lymphedematous limbs. Demographic data and intraoperative findings were recorded. Preoperative and postoperative limb volumes were measured with magnetic resonance volumetry. The primary outcome was the limb volume measured 6 months post-LVA. Results: The median duration of lymphedema before LVA was 10.5 (4.9–15.3) years. The median waiting time between VLNT and LVA was 41.4 (22.3–97.9) months. The median volume gained in the lymphedematous limb was 3836 (2505–4584) milliliters (mL). The median post-LVA follow-up period was 18 (6–30) months. Significant 6-month and 1-year post-LVA percentage volume reductions were found compared to pre-LVA volume (both p < 0.001). Conclusion: Based on the results from this study, the authors recommend the use of LVA as a secondary procedure for post-VLNT patients seeking further improvement.

show abstract

Section: Discussionmentioning

confidence: 99%

Lower Limb Lymphedema Patients Can Still Benefit from Supermicrosurgical Lymphaticovenous Anastomosis (LVA) after Vascularized Lymph Node Flap Transfer (VLNT) as Delayed Lymphatic Reconstruction—A Retrospective Cohort Study

Yang

Hayashi

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Most case reports highlight the use of one technique either physiologic or debulking however good outcomes have been noted with combination techniques. In China, for example, Chen et al (2020) (20), were able to achieve good functional outcomes with combined lymph node transfer and modified Charles' procedure. The final outcome, similar to ours, was quite satisfactory.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of unilateral lower limb lymphedema in combination of debulking and physiologic procedures: a case report

Gathariki¹,

Khainga²,

Aluora³

et al. 2022

Ann Afr Surg.

View full text Add to dashboard Cite

Lymphedema has a high incidence and various causes including filariasis in developing countries and as complications following oncological surgery in developed countries. It reduces patients’ quality of life, productivity and currently lacks a cure. Current management involves debulking or physiological methods, with debridement being the preferred debulking method and lymph node transfer, the preferred physiological option. Most reports on the management of lymphedema or its associated outcomes have reported the use of either of these modalities with favourable outcomes, albeit some complications. There is however paucity of documented cases where a patient underwent both debulking and physiological treatment in management of chronic lymphedema and our case study reports on the same, with favourable outcome and minimal complications. Our patient, a 30 year old female presented with an 8 year history of slowly progressive right lower limb oedema. Physical examination revealed marked right lower limb swelling that was non- pitting, non-tender, erythematous, with marked thickening of skin, yellowing of the nails and a positive stemmer sign. Lymphoscintigraphy revealed hypoplastic lymphatic channels and faulty valves. Debulking using modified Charles procedure and vascularised lymph node transfer were done within a one month interval. Ten months later, she is doing well with no relapse.

show abstract

“…Early engraftment enhances the viability of grafts and thin flaps [2,3,4,70,75]. Full-thickness skin grafts (FTSG) may receive dermal plexus perfusion from their margins.…”

Section: Tissue Viability Engraftment and Plexus-to-plexus Appositionmentioning

confidence: 99%

“…The suprafascial plexus is easily maintained by dissecting fat off it [79][80][81]. In patients with thick fascia, as seen in chronic lymphedema, deep subfascial plexi are made accessible by fascial thinning to 1 mm [75].…”

Section: Tissue Viability Engraftment and Plexus-to-plexus Appositionmentioning

confidence: 99%

See 1 more Smart Citation

Redefining Fasciocutaneous Microanatomy: An Illustrated Review of Current Concepts and Their Clinical Correlates

Bajwa,

Afzal,

Hussain

et al. 2023

IMJ

View full text Add to dashboard Cite

Emerging anatomical concepts challenge microsurgical dogma. The current anatomy of the skin and subcutaneous tissue was reviewed with the objective of challenging the existing understanding of fasciocutaneous microanatomy using an updated anatomical model. Numerical anatomical data were compiled and utilized to create an updated and scaled model, defining integumentary neuroarterial, venolymphatic, and connective tissue systems. Additionally, a second model detailing the neurovasculature of the head and neck is presented, illustrating the relations of perforator arteries. Microangiosomes, the strength of their connections, and their relation to dissection planes are described. Clinically relevant structures are outlined, along with general principles and regional variations. We explore the viability of dermal plexus flaps and their potential for engraftment through plexus-to-plexus apposition. A comparison is drawn between subdermal and deep-dermal plexi. Furthermore, the peculiarities of head and neck perfusion and lymphatic drainage are discussed. These models inform our approach to dissection planes, fluid injection depths, flap viability, neurotization, post-inflammatory hyperpigmentation, tissue engraftment, debulking, and head and neck lymphatic drainage. This illustrated review offers an updated understanding of fasciocutaneous microanatomy and how to safely utilize it.

show abstract

Long-term functional outcomes upon application of split-thickness skin graft around major joints in HCC (Hung-Chi Chen)-modified Charles’ procedure for advanced lymphedema

Cited by 5 publications

References 12 publications

Lower Limb Lymphedema Patients Can Still Benefit from Supermicrosurgical Lymphaticovenous Anastomosis (LVA) after Vascularized Lymph Node Flap Transfer (VLNT) as Delayed Lymphatic Reconstruction—A Retrospective Cohort Study

Lower Limb Lymphedema Patients Can Still Benefit from Supermicrosurgical Lymphaticovenous Anastomosis (LVA) after Vascularized Lymph Node Flap Transfer (VLNT) as Delayed Lymphatic Reconstruction—A Retrospective Cohort Study

Surgical management of unilateral lower limb lymphedema in combination of debulking and physiologic procedures: a case report

Redefining Fasciocutaneous Microanatomy: An Illustrated Review of Current Concepts and Their Clinical Correlates

Contact Info

Product

Resources

About