The Contralateral Rectus Abdominis Musculocutaneous Flap for Treatment of Lower Extremity Lymphedema
Identifieur interne : 006791 ( Main/Exploration ); précédent : 006790; suivant : 006792The Contralateral Rectus Abdominis Musculocutaneous Flap for Treatment of Lower Extremity Lymphedema
Auteurs : Brian M. Parrett [États-Unis] ; Jerome Sepic [États-Unis] ; Julian J. Pribaz [États-Unis]Source :
- Annals of plastic surgery [ 0148-7043 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
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.
Affiliations:
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Parrett</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Sepic, Jerome" sort="Sepic, Jerome" uniqKey="Sepic J" first="Jerome" last="Sepic">Jerome Sepic</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Pribaz, Julian J" sort="Pribaz, Julian J" uniqKey="Pribaz J" first="Julian J." last="Pribaz">Julian J. Pribaz</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Annals of plastic surgery</title><title level="j" type="abbreviated">Ann. plast. surg.</title><idno type="ISSN">0148-7043</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Annals of plastic surgery</title><title level="j" type="abbreviated">Ann. plast. surg.</title><idno type="ISSN">0148-7043</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Contralateral</term><term>Lower extremity</term><term>Lymphedema</term><term>Musculocutaneous flap</term><term>Plastic surgery</term><term>Rectus abdominis muscle</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term><term>Controlatéral</term><term>Muscle grand droit abdomen</term><term>Lambeau musculocutané</term><term>Traitement</term><term>Extrémité inférieure</term><term>Chirurgie plastique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">: 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.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li></region></list><tree><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><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></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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