Lymphedema of the Upper Extremity following Supraclavicular Lymph Node Harvest

The use of supraclavicular free flap with vascularized lymph node transfer for treatment of lymphedema: A prospective study of 100 consecutive cases

“…There has been one anecdotal communication to the senior author that upper limb lymphatic drainage to the supraclavicular area has been seen on an injection study. There has been one case‐report of donor‐site arm lymphedema following SC flap of a same case by two different groups of authors . It is uncertain what type of approach was used in this particular case, but when the photo of the case is carefully seen, the donor site scar appears very different than ours in terms of the location as well as the extent of the deformity.…”

Staged surgical treatment of extremity lymphedema with dual gastroepiploic vascularized lymph node transfers followed by suction‐assisted lipectomy—A prospective study

“…The most critical factor for donor site selection is the propensity for iatrogenic lymphedema . As both the groin and supraclavicular areas have been implicated in this complication, surgeons have explored alternatives such as the submental and lateral thoracic areas . However, the former carries the risk of facial nerve injury and a more conspicuous scar, whereas the latter ideally requires reverse mapping for safe harvest .…”

5‐step harvest of supraclavicular lymph nodes as vascularized free tissue transfer for treatment of lymphedema

“…While not a simple flap to raise by any means, the main advantages of this technique are reliable vascularized lymph nodes, the inconspicuous lower neck donor site scar, and if harvested in a safe manner, low risk of developing harvest related lymphedema. To date, there has only been one report of such an occurrence, though details of the harvest were unknown and direct causality not firmly established . The main points to bear in mind when harvesting the flap are the location of the phrenic nerve and risk of main thoracic duct injury.…”