The contralateral rectus abdominis musculocutaneous flap for treatment of lower extremity lymphedema.
Identifieur interne : 005F94 ( Main/Exploration ); précédent : 005F93; suivant : 005F95The contralateral rectus abdominis musculocutaneous flap for treatment of lower extremity lymphedema.
Auteurs : Brian M. Parrett [États-Unis] ; Jerome Sepic ; Julian J. PribazSource :
- Annals of plastic surgery [ 1536-3708 ] ; 2009.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- surgery : Leg, Lymphedema.
- transplantation : Rectus Abdominis.
- Adult, Aged, Female, Humans, Male, Middle Aged, Surgical Flaps.
Abstract
Lymphedema is common after inguinal lymphadenectomy or resection of groin tumors. Animal studies have shown success using the rectus abdominis musculocutaneous (RAM) flap as a treatment for lymphedema. Four patients with acquired lower extremity lymphedema were treated with a contralateral RAM flap with an inferior cutaneous pedicle left intact to facilitate lymphatic drainage into the unaffected groin. One patient also had lymphaticovenous anastomoses performed during flap transfer. All flaps survived with no postoperative complications. With a mean follow-up of 31 months, the mean reduction in limb circumference from the preoperative excess was 81% at the thigh, 70% at the calf, and 71% at the ankle. None of the patients with recurrent cellulitis had further incidences of groin cellulitis. Two patients required future flap debulking. Lymphoscintigraphy was performed in 1 patient and demonstrated reconstitution of lymphatic flow from the affected leg through the flap. According to this preliminary study, transfer of a contralateral RAM flap to the groin of a lymphedematous leg improves lymphedema and decreases the incidence of cellulitis.
DOI: 10.1097/SAP.0b013e31817439de
PubMed: 19131725
Affiliations:
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Le document en format XML
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Animal studies have shown success using the rectus abdominis musculocutaneous (RAM) flap as a treatment for lymphedema. Four patients with acquired lower extremity lymphedema were treated with a contralateral RAM flap with an inferior cutaneous pedicle left intact to facilitate lymphatic drainage into the unaffected groin. One patient also had lymphaticovenous anastomoses performed during flap transfer. All flaps survived with no postoperative complications. With a mean follow-up of 31 months, the mean reduction in limb circumference from the preoperative excess was 81% at the thigh, 70% at the calf, and 71% at the ankle. None of the patients with recurrent cellulitis had further incidences of groin cellulitis. Two patients required future flap debulking. Lymphoscintigraphy was performed in 1 patient and demonstrated reconstitution of lymphatic flow from the affected leg through the flap. According to this preliminary study, transfer of a contralateral RAM flap to the groin of a lymphedematous leg improves lymphedema and decreases the incidence of cellulitis.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li></region></list><tree><noCountry><name sortKey="Pribaz, Julian J" sort="Pribaz, Julian J" uniqKey="Pribaz J" first="Julian J" last="Pribaz">Julian J. Pribaz</name><name sortKey="Sepic, Jerome" sort="Sepic, Jerome" uniqKey="Sepic J" first="Jerome" last="Sepic">Jerome Sepic</name></noCountry><country name="États-Unis"><region name="Massachusetts"><name sortKey="Parrett, Brian M" sort="Parrett, Brian M" uniqKey="Parrett B" first="Brian M" last="Parrett">Brian M. Parrett</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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