LymphedemaV1, PascalFrancis, Corpus, bibRecord, 000310

Radical Reduction of Upper Extremity Lymphedema With Preservation of Perforators

Identifieur interne : 000310 ( PascalFrancis/Corpus ); précédent : 000309; suivant : 000311

Radical Reduction of Upper Extremity Lymphedema With Preservation of Perforators

Auteurs : Christopher J. Salgado ; Paolo Sassu ; Bahar Bassiri Gharb ; Stefano Spanio Di Spilimbergo ; Samir Mardini ; Hung-Chi Chen

Source :

Annals of plastic surgery [ 0148-7043 ] ; 2009.

RBID : Pascal:09-0382025

Descripteurs français

Pascal (Inist)
- Lymphoedème, Réduction, Extrémité supérieure, Membre supérieur, Chirurgie plastique, Traitement.

English descriptors

KwdEn :
- Lymphedema, Plastic surgery, Reduction, Treatment, Upper extremity, Upper limb.

Abstract

Excisional procedures have been successfully utilized by different authors in multistage treatment of upper extremity lymphedema. We have used microsurgical principles of perforator flap surgery in order to develop a one-stage procedure that enables a radical reduction of the lymphedematous tissue with preservation of the vascular supply to the overlying skin. Between March 2000 and February 2007, 11 patients affected by late stage II lymphedema underwent radical reduction of the affected tissues with preservation of perforators. Perforator vessels from the radial and posterior interosseous arteries were identified and through medial and lateral forearm incisions, skin flaps were raised off the underlying lymphedematous tissue and the affected tissue was removed off the deep fascia. At a mean follow-up of 17.8 months the average percentage reductions above and below the elbow, at the wrist, and the hand were 15.1%,20.7%,0.5%, and 3.6%, respectively. Statistical analysis showed significant circumference reduction above and below the elbow (P = 0.048 and 0.022, respectively) but not at the wrist and hand. There were no cases of wound breakdown, skin necrosis, or cellulitis in the postoperative period. Four patients complained of mild numbness confined to the vicinity of the surgical incisions. Microvascular principles applied to the radical excision of the subcutaneous tissue seems to offer a new promising one-stage surgical procedure in patients affected by upper extremity lymphedema that has failed conservative therapy.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

A01	`01`	`1`		`@0 0148-7043`
A02	`01`			`@0 APCSD4`
A03		`1`		`@0 Ann. plast. surg.`
A05				`@2 63`
A06				`@2 3`
A08	`01`	`1`	`ENG`	`@1 Radical Reduction of Upper Extremity Lymphedema With Preservation of Perforators`
A11	`01`	`1`		`@1 SALGADO (Christopher J.)`
A11	`02`	`1`		`@1 SASSU (Paolo)`
A11	`03`	`1`		`@1 BASSIRI GHARB (Bahar)`
A11	`04`	`1`		`@1 SPANIO DI SPILIMBERGO (Stefano)`
A11	`05`	`1`		`@1 MARDINI (Samir)`
A11	`06`	`1`		`@1 CHEN (Hung-Chi)`
A14	`01`			`@1 Department of Plastic Surgery, University Hospitals Cleveland/Case Western Reserve University @2 Cleveland, Ohio @3 USA @Z 1 aut.`
A14	`02`			`@1 Department of Plastic Surgery, E-Da Hospital/I-Shou University @2 Kaohsiung County @3 TWN @Z 2 aut. @Z 3 aut. @Z 4 aut. @Z 6 aut.`
A14	`03`			`@1 Division of Plastic Surgery, Mayo Clinic @2 Rochester, MN @3 USA @Z 5 aut.`
A20				`@1 302-306`
A21				`@1 2009`
A23	`01`			`@0 ENG`
A43	`01`			`@1 INIST @2 18346 @5 354000171876760120`
A44				`@0 0000 @1 © 2009 INIST-CNRS. All rights reserved.`
A45				`@0 21 ref.`
A47	`01`	`1`		`@0 09-0382025`
A60				`@1 P`
A61				`@0 A`
A64	`01`	`1`		`@0 Annals of plastic surgery`
A66	`01`			`@0 USA`
C01	`01`		`ENG`	@0 Excisional procedures have been successfully utilized by different authors in multistage treatment of upper extremity lymphedema. We have used microsurgical principles of perforator flap surgery in order to develop a one-stage procedure that enables a radical reduction of the lymphedematous tissue with preservation of the vascular supply to the overlying skin. Between March 2000 and February 2007, 11 patients affected by late stage II lymphedema underwent radical reduction of the affected tissues with preservation of perforators. Perforator vessels from the radial and posterior interosseous arteries were identified and through medial and lateral forearm incisions, skin flaps were raised off the underlying lymphedematous tissue and the affected tissue was removed off the deep fascia. At a mean follow-up of 17.8 months the average percentage reductions above and below the elbow, at the wrist, and the hand were 15.1%,20.7%,0.5%, and 3.6%, respectively. Statistical analysis showed significant circumference reduction above and below the elbow (P = 0.048 and 0.022, respectively) but not at the wrist and hand. There were no cases of wound breakdown, skin necrosis, or cellulitis in the postoperative period. Four patients complained of mild numbness confined to the vicinity of the surgical incisions. Microvascular principles applied to the radical excision of the subcutaneous tissue seems to offer a new promising one-stage surgical procedure in patients affected by upper extremity lymphedema that has failed conservative therapy.
C02	`01`	`X`		`@0 002B25`
C02	`02`	`X`		`@0 002B12B04`
C03	`01`	`X`	`FRE`	`@0 Lymphoedème @5 01`
C03	`01`	`X`	`ENG`	`@0 Lymphedema @5 01`
C03	`01`	`X`	`SPA`	`@0 Linfedema @5 01`
C03	`02`	`X`	`FRE`	`@0 Réduction @5 07`
C03	`02`	`X`	`ENG`	`@0 Reduction @5 07`
C03	`02`	`X`	`SPA`	`@0 Reducción @5 07`
C03	`03`	`X`	`FRE`	`@0 Extrémité supérieure @5 08`
C03	`03`	`X`	`ENG`	`@0 Upper extremity @5 08`
C03	`03`	`X`	`SPA`	`@0 Extremidad superior @5 08`
C03	`04`	`X`	`FRE`	`@0 Membre supérieur @5 09`
C03	`04`	`X`	`ENG`	`@0 Upper limb @5 09`
C03	`04`	`X`	`SPA`	`@0 Miembro superior @5 09`
C03	`05`	`X`	`FRE`	`@0 Chirurgie plastique @5 13`
C03	`05`	`X`	`ENG`	`@0 Plastic surgery @5 13`
C03	`05`	`X`	`SPA`	`@0 Cirugía plástica @5 13`
C03	`06`	`X`	`FRE`	`@0 Traitement @5 30`
C03	`06`	`X`	`ENG`	`@0 Treatment @5 30`
C03	`06`	`X`	`SPA`	`@0 Tratamiento @5 30`
C07	`01`	`X`	`FRE`	`@0 Pathologie de l'appareil circulatoire @5 37`
C07	`01`	`X`	`ENG`	`@0 Cardiovascular disease @5 37`
C07	`01`	`X`	`SPA`	`@0 Aparato circulatorio patología @5 37`
C07	`02`	`X`	`FRE`	`@0 Pathologie des vaisseaux lymphatiques @5 38`
C07	`02`	`X`	`ENG`	`@0 Lymphatic vessel disease @5 38`
C07	`02`	`X`	`SPA`	`@0 Linfático patología @5 38`
N21				`@1 278`
N44	`01`			`@1 OTO`
N82				`@1 OTO`

Format Inist (serveur)

NO :	PASCAL 09-0382025 INIST
ET :	Radical Reduction of Upper Extremity Lymphedema With Preservation of Perforators
AU :	SALGADO (Christopher J.); SASSU (Paolo); BASSIRI GHARB (Bahar); SPANIO DI SPILIMBERGO (Stefano); MARDINI (Samir); CHEN (Hung-Chi)
AF :	Department of Plastic Surgery, University Hospitals Cleveland/Case Western Reserve University/Cleveland, Ohio/Etats-Unis (1 aut.); Department of Plastic Surgery, E-Da Hospital/I-Shou University/Kaohsiung County/Taïwan (2 aut., 3 aut., 4 aut., 6 aut.); Division of Plastic Surgery, Mayo Clinic/Rochester, MN/Etats-Unis (5 aut.)
DT :	Publication en série; Niveau analytique
SO :	Annals of plastic surgery; ISSN 0148-7043; Coden APCSD4; Etats-Unis; Da. 2009; Vol. 63; No. 3; Pp. 302-306; Bibl. 21 ref.
LA :	Anglais
EA :	Excisional procedures have been successfully utilized by different authors in multistage treatment of upper extremity lymphedema. We have used microsurgical principles of perforator flap surgery in order to develop a one-stage procedure that enables a radical reduction of the lymphedematous tissue with preservation of the vascular supply to the overlying skin. Between March 2000 and February 2007, 11 patients affected by late stage II lymphedema underwent radical reduction of the affected tissues with preservation of perforators. Perforator vessels from the radial and posterior interosseous arteries were identified and through medial and lateral forearm incisions, skin flaps were raised off the underlying lymphedematous tissue and the affected tissue was removed off the deep fascia. At a mean follow-up of 17.8 months the average percentage reductions above and below the elbow, at the wrist, and the hand were 15.1%,20.7%,0.5%, and 3.6%, respectively. Statistical analysis showed significant circumference reduction above and below the elbow (P = 0.048 and 0.022, respectively) but not at the wrist and hand. There were no cases of wound breakdown, skin necrosis, or cellulitis in the postoperative period. Four patients complained of mild numbness confined to the vicinity of the surgical incisions. Microvascular principles applied to the radical excision of the subcutaneous tissue seems to offer a new promising one-stage surgical procedure in patients affected by upper extremity lymphedema that has failed conservative therapy.
CC :	002B25; 002B12B04
FD :	Lymphoedème; Réduction; Extrémité supérieure; Membre supérieur; Chirurgie plastique; Traitement
FG :	Pathologie de l'appareil circulatoire; Pathologie des vaisseaux lymphatiques
ED :	Lymphedema; Reduction; Upper extremity; Upper limb; Plastic surgery; Treatment
EG :	Cardiovascular disease; Lymphatic vessel disease
SD :	Linfedema; Reducción; Extremidad superior; Miembro superior; Cirugía plástica; Tratamiento
LO :	INIST-18346.354000171876760120
ID :	09-0382025

Links to Exploration step

Pascal:09-0382025

Le document en format XML

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<author><name sortKey="Bassiri Gharb, Bahar" sort="Bassiri Gharb, Bahar" uniqKey="Bassiri Gharb B" first="Bahar" last="Bassiri Gharb">Bahar Bassiri Gharb</name>
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<front><div type="abstract" xml:lang="en">Excisional procedures have been successfully utilized by different authors in multistage treatment of upper extremity lymphedema. We have used microsurgical principles of perforator flap surgery in order to develop a one-stage procedure that enables a radical reduction of the lymphedematous tissue with preservation of the vascular supply to the overlying skin. Between March 2000 and February 2007, 11 patients affected by late stage II lymphedema underwent radical reduction of the affected tissues with preservation of perforators. Perforator vessels from the radial and posterior interosseous arteries were identified and through medial and lateral forearm incisions, skin flaps were raised off the underlying lymphedematous tissue and the affected tissue was removed off the deep fascia. At a mean follow-up of 17.8 months the average percentage reductions above and below the elbow, at the wrist, and the hand were 15.1%,20.7%,0.5%, and 3.6%, respectively. Statistical analysis showed significant circumference reduction above and below the elbow (P = 0.048 and 0.022, respectively) but not at the wrist and hand. There were no cases of wound breakdown, skin necrosis, or cellulitis in the postoperative period. Four patients complained of mild numbness confined to the vicinity of the surgical incisions. Microvascular principles applied to the radical excision of the subcutaneous tissue seems to offer a new promising one-stage surgical procedure in patients affected by upper extremity lymphedema that has failed conservative therapy.</div>
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<fC01 i1="01" l="ENG"><s0>Excisional procedures have been successfully utilized by different authors in multistage treatment of upper extremity lymphedema. We have used microsurgical principles of perforator flap surgery in order to develop a one-stage procedure that enables a radical reduction of the lymphedematous tissue with preservation of the vascular supply to the overlying skin. Between March 2000 and February 2007, 11 patients affected by late stage II lymphedema underwent radical reduction of the affected tissues with preservation of perforators. Perforator vessels from the radial and posterior interosseous arteries were identified and through medial and lateral forearm incisions, skin flaps were raised off the underlying lymphedematous tissue and the affected tissue was removed off the deep fascia. At a mean follow-up of 17.8 months the average percentage reductions above and below the elbow, at the wrist, and the hand were 15.1%,20.7%,0.5%, and 3.6%, respectively. Statistical analysis showed significant circumference reduction above and below the elbow (P = 0.048 and 0.022, respectively) but not at the wrist and hand. There were no cases of wound breakdown, skin necrosis, or cellulitis in the postoperative period. Four patients complained of mild numbness confined to the vicinity of the surgical incisions. Microvascular principles applied to the radical excision of the subcutaneous tissue seems to offer a new promising one-stage surgical procedure in patients affected by upper extremity lymphedema that has failed conservative therapy.</s0>
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<s5>09</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Upper limb</s0>
<s5>09</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Miembro superior</s0>
<s5>09</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Chirurgie plastique</s0>
<s5>13</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Plastic surgery</s0>
<s5>13</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Cirugía plástica</s0>
<s5>13</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Traitement</s0>
<s5>30</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Treatment</s0>
<s5>30</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Tratamiento</s0>
<s5>30</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Cardiovascular disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Pathologie des vaisseaux lymphatiques</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Linfático patología</s0>
<s5>38</s5>
</fC07>
<fN21><s1>278</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
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<server><NO>PASCAL 09-0382025 INIST</NO>
<ET>Radical Reduction of Upper Extremity Lymphedema With Preservation of Perforators</ET>
<AU>SALGADO (Christopher J.); SASSU (Paolo); BASSIRI GHARB (Bahar); SPANIO DI SPILIMBERGO (Stefano); MARDINI (Samir); CHEN (Hung-Chi)</AU>
<AF>Department of Plastic Surgery, University Hospitals Cleveland/Case Western Reserve University/Cleveland, Ohio/Etats-Unis (1 aut.); Department of Plastic Surgery, E-Da Hospital/I-Shou University/Kaohsiung County/Taïwan (2 aut., 3 aut., 4 aut., 6 aut.); Division of Plastic Surgery, Mayo Clinic/Rochester, MN/Etats-Unis (5 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Annals of plastic surgery; ISSN 0148-7043; Coden APCSD4; Etats-Unis; Da. 2009; Vol. 63; No. 3; Pp. 302-306; Bibl. 21 ref.</SO>
<LA>Anglais</LA>
<EA>Excisional procedures have been successfully utilized by different authors in multistage treatment of upper extremity lymphedema. We have used microsurgical principles of perforator flap surgery in order to develop a one-stage procedure that enables a radical reduction of the lymphedematous tissue with preservation of the vascular supply to the overlying skin. Between March 2000 and February 2007, 11 patients affected by late stage II lymphedema underwent radical reduction of the affected tissues with preservation of perforators. Perforator vessels from the radial and posterior interosseous arteries were identified and through medial and lateral forearm incisions, skin flaps were raised off the underlying lymphedematous tissue and the affected tissue was removed off the deep fascia. At a mean follow-up of 17.8 months the average percentage reductions above and below the elbow, at the wrist, and the hand were 15.1%,20.7%,0.5%, and 3.6%, respectively. Statistical analysis showed significant circumference reduction above and below the elbow (P = 0.048 and 0.022, respectively) but not at the wrist and hand. There were no cases of wound breakdown, skin necrosis, or cellulitis in the postoperative period. Four patients complained of mild numbness confined to the vicinity of the surgical incisions. Microvascular principles applied to the radical excision of the subcutaneous tissue seems to offer a new promising one-stage surgical procedure in patients affected by upper extremity lymphedema that has failed conservative therapy.</EA>
<CC>002B25; 002B12B04</CC>
<FD>Lymphoedème; Réduction; Extrémité supérieure; Membre supérieur; Chirurgie plastique; Traitement</FD>
<FG>Pathologie de l'appareil circulatoire; Pathologie des vaisseaux lymphatiques</FG>
<ED>Lymphedema; Reduction; Upper extremity; Upper limb; Plastic surgery; Treatment</ED>
<EG>Cardiovascular disease; Lymphatic vessel disease</EG>
<SD>Linfedema; Reducción; Extremidad superior; Miembro superior; Cirugía plástica; Tratamiento</SD>
<LO>INIST-18346.354000171876760120</LO>
<ID>09-0382025</ID>
</server>
</inist>
</record>

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Radical Reduction of Upper Extremity Lymphedema With Preservation of Perforators

Radical Reduction of Upper Extremity Lymphedema With Preservation of Perforators

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