Management of unusual genital lymphedema complication after Fournier’s gangrene: a case report
Identifieur interne : 001F18 ( Pmc/Curation ); précédent : 001F17; suivant : 001F19Management of unusual genital lymphedema complication after Fournier’s gangrene: a case report
Auteurs : Oanna Meyer Ganz [Suisse] ; Raphaël Gumener [Suisse] ; Pascal Gervaz [Suisse] ; Julien Schwartz [Suisse] ; Brigitte Pittet-Cuénod [Suisse]Source :
- BMC Surgery [ 1471-2482 ] ; 2012.
Abstract
Fournier’s gangrene is a bacterial infection characterized by necrotizing fasciitis, skin and soft tissue involvement, and eventually myositis of the perineal region. Aggressive debridement of devitalized tissue and overlying skin is of paramount importance, but often leaves large defects to be reconstructed. The present case reports successful extensive perineal defects coverage following Fournier’s gangrene and management of subsequent penile lymphoedema impairing sexual function in a young patient.
Following perianal abscess drainage, a healthy young man presented with scrotal pain. Fournier’s gangrene was diagnosed and treated with multiple surgical debridements. Tissue excision extended through the entire perineal area, base of the penile shaft, lower abdominal region, the inner thighs, and gluteal region, corresponding to 12% of the total body surface area. After serial debridements and negative pressure dressings, the defect was covered by two stages of skin grafting. Graft take was 90%. Healing was achieved without hypertrophic or retractile scar. However, chronic penile lymphedema remained and was first treated with compressive garments for 2 years. Upon failure of this conservative approach, we performed a circumcision, but only a “penile lift” allowed a satisfactory esthetical and functional result.
Fournier’s gangrene can be complicated by a chronic lymphedema of the penis. Conservative treatment is likely to fail in severe cases and can be treated surgically by “penile lift”.
Url:
DOI: 10.1186/1471-2482-12-26
PubMed: 23259537
PubMed Central: 3543169
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: Pour aller vers cette notice dans l'étape Curation :001F19
Links to Exploration step
PMC:3543169Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Management of unusual genital lymphedema complication after Fournier’s gangrene: a case report</title>
<author><name sortKey="Meyer Ganz, Oanna" sort="Meyer Ganz, Oanna" uniqKey="Meyer Ganz O" first="Oanna" last="Meyer Ganz">Oanna Meyer Ganz</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gumener, Raphael" sort="Gumener, Raphael" uniqKey="Gumener R" first="Raphaël" last="Gumener">Raphaël Gumener</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gervaz, Pascal" sort="Gervaz, Pascal" uniqKey="Gervaz P" first="Pascal" last="Gervaz">Pascal Gervaz</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Department of Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Schwartz, Julien" sort="Schwartz, Julien" uniqKey="Schwartz J" first="Julien" last="Schwartz">Julien Schwartz</name>
<affiliation wicri:level="1"><nlm:aff id="I3">Division of Urology, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Division of Urology, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pittet Cuenod, Brigitte" sort="Pittet Cuenod, Brigitte" uniqKey="Pittet Cuenod B" first="Brigitte" last="Pittet-Cuénod">Brigitte Pittet-Cuénod</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">23259537</idno>
<idno type="pmc">3543169</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543169</idno>
<idno type="RBID">PMC:3543169</idno>
<idno type="doi">10.1186/1471-2482-12-26</idno>
<date when="2012">2012</date>
<idno type="wicri:Area/Pmc/Corpus">001F19</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001F19</idno>
<idno type="wicri:Area/Pmc/Curation">001F18</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001F18</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Management of unusual genital lymphedema complication after Fournier’s gangrene: a case report</title>
<author><name sortKey="Meyer Ganz, Oanna" sort="Meyer Ganz, Oanna" uniqKey="Meyer Ganz O" first="Oanna" last="Meyer Ganz">Oanna Meyer Ganz</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gumener, Raphael" sort="Gumener, Raphael" uniqKey="Gumener R" first="Raphaël" last="Gumener">Raphaël Gumener</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gervaz, Pascal" sort="Gervaz, Pascal" uniqKey="Gervaz P" first="Pascal" last="Gervaz">Pascal Gervaz</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Department of Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Schwartz, Julien" sort="Schwartz, Julien" uniqKey="Schwartz J" first="Julien" last="Schwartz">Julien Schwartz</name>
<affiliation wicri:level="1"><nlm:aff id="I3">Division of Urology, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Division of Urology, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pittet Cuenod, Brigitte" sort="Pittet Cuenod, Brigitte" uniqKey="Pittet Cuenod B" first="Brigitte" last="Pittet-Cuénod">Brigitte Pittet-Cuénod</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">BMC Surgery</title>
<idno type="eISSN">1471-2482</idno>
<imprint><date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Fournier’s gangrene is a bacterial infection characterized by necrotizing fasciitis, skin and soft tissue involvement, and eventually myositis of the perineal region. Aggressive debridement of devitalized tissue and overlying skin is of paramount importance, but often leaves large defects to be reconstructed. The present case reports successful extensive perineal defects coverage following Fournier’s gangrene and management of subsequent penile lymphoedema impairing sexual function in a young patient.</p>
</sec>
<sec><title>Case presentation</title>
<p>Following perianal abscess drainage, a healthy young man presented with scrotal pain. Fournier’s gangrene was diagnosed and treated with multiple surgical debridements. Tissue excision extended through the entire perineal area, base of the penile shaft, lower abdominal region, the inner thighs, and gluteal region, corresponding to 12% of the total body surface area. After serial debridements and negative pressure dressings, the defect was covered by two stages of skin grafting. Graft take was 90%. Healing was achieved without hypertrophic or retractile scar. However, chronic penile lymphedema remained and was first treated with compressive garments for 2 years. Upon failure of this conservative approach, we performed a circumcision, but only a “penile lift” allowed a satisfactory esthetical and functional result.</p>
</sec>
<sec><title>Conclusion</title>
<p>Fournier’s gangrene can be complicated by a chronic lymphedema of the penis. Conservative treatment is likely to fail in severe cases and can be treated surgically by “penile lift”.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Binder, Jp" uniqKey="Binder J">JP Binder</name>
</author>
<author><name sortKey="Revol, M" uniqKey="Revol M">M Revol</name>
</author>
<author><name sortKey="Servant, Jm" uniqKey="Servant J">JM Servant</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Fournier, Aj" uniqKey="Fournier A">AJ Fournier</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ferreira, Pc" uniqKey="Ferreira P">PC Ferreira</name>
</author>
<author><name sortKey="Reis, Jc" uniqKey="Reis J">JC Reis</name>
</author>
<author><name sortKey="Amarante, Jm" uniqKey="Amarante J">JM Amarante</name>
</author>
<author><name sortKey="Silva, Ac" uniqKey="Silva A">AC Silva</name>
</author>
<author><name sortKey="Pinho, Cj" uniqKey="Pinho C">CJ Pinho</name>
</author>
<author><name sortKey="Oliveira, Ic" uniqKey="Oliveira I">IC Oliveira</name>
</author>
<author><name sortKey="Da Silva, Pn" uniqKey="Da Silva P">PN da Silva</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Morpurgo, E" uniqKey="Morpurgo E">E Morpurgo</name>
</author>
<author><name sortKey="Galandiuk, S" uniqKey="Galandiuk S">S Galandiuk</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Moslemi, Mk" uniqKey="Moslemi M">MK Moslemi</name>
</author>
<author><name sortKey="Sadighi Gilani, Ma" uniqKey="Sadighi Gilani M">MA Sadighi Gilani</name>
</author>
<author><name sortKey="Moslemi, Aa" uniqKey="Moslemi A">AA Moslemi</name>
</author>
<author><name sortKey="Arabshahi, A" uniqKey="Arabshahi A">A Arabshahi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hsu, H" uniqKey="Hsu H">H Hsu</name>
</author>
<author><name sortKey="Lin, Cm" uniqKey="Lin C">CM Lin</name>
</author>
<author><name sortKey="Sun, Tb" uniqKey="Sun T">TB Sun</name>
</author>
<author><name sortKey="Cheng, Lf" uniqKey="Cheng L">LF Cheng</name>
</author>
<author><name sortKey="Chien, Sh" uniqKey="Chien S">SH Chien</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gumener, R" uniqKey="Gumener R">R Gumener</name>
</author>
<author><name sortKey="Montandon, D" uniqKey="Montandon D">D Montandon</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rawlins, Jm" uniqKey="Rawlins J">JM Rawlins</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cuccia, G" uniqKey="Cuccia G">G Cuccia</name>
</author>
<author><name sortKey="Mucciardi, G" uniqKey="Mucciardi G">G Mucciardi</name>
</author>
<author><name sortKey="Morgia, G" uniqKey="Morgia G">G Morgia</name>
</author>
<author><name sortKey="Stagno D Alcontres, F" uniqKey="Stagno D Alcontres F">F Stagno D'Alcontres</name>
</author>
<author><name sortKey="Gali, A" uniqKey="Gali A">A Galì</name>
</author>
<author><name sortKey="Cotrufo, S" uniqKey="Cotrufo S">S Cotrufo</name>
</author>
<author><name sortKey="Romeo, M" uniqKey="Romeo M">M Romeo</name>
</author>
<author><name sortKey="Magno, C" uniqKey="Magno C">C Magno</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tahmaz, L" uniqKey="Tahmaz L">L Tahmaz</name>
</author>
<author><name sortKey="Erdemir, F" uniqKey="Erdemir F">F Erdemir</name>
</author>
<author><name sortKey="Kibar, Y" uniqKey="Kibar Y">Y Kibar</name>
</author>
<author><name sortKey="Cosar, A" uniqKey="Cosar A">A Cosar</name>
</author>
<author><name sortKey="Yalcyn, O" uniqKey="Yalcyn O">O Yalcyn</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Sauer, Pf" uniqKey="Sauer P">PF Sauer</name>
</author>
<author><name sortKey="Bueschen, Aj" uniqKey="Bueschen A">AJ Bueschen</name>
</author>
<author><name sortKey="Vasconez, Lo" uniqKey="Vasconez L">LO Vasconez</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="case-report" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Surg</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Surg</journal-id>
<journal-title-group><journal-title>BMC Surgery</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2482</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23259537</article-id>
<article-id pub-id-type="pmc">3543169</article-id>
<article-id pub-id-type="publisher-id">1471-2482-12-26</article-id>
<article-id pub-id-type="doi">10.1186/1471-2482-12-26</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group><article-title>Management of unusual genital lymphedema complication after Fournier’s gangrene: a case report</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Meyer Ganz</surname>
<given-names>Oanna</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>oanna.meyer@hcuge.ch</email>
</contrib>
<contrib contrib-type="author" id="A2"><name><surname>Gumener</surname>
<given-names>Raphaël</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>rgumener@worldcom.ch</email>
</contrib>
<contrib contrib-type="author" id="A3"><name><surname>Gervaz</surname>
<given-names>Pascal</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>pascalgervaz@gmail.com</email>
</contrib>
<contrib contrib-type="author" id="A4"><name><surname>Schwartz</surname>
<given-names>Julien</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>julien.schwartz@hcuge.ch</email>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>Pittet-Cuénod</surname>
<given-names>Brigitte</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>brigitte.pittet-cuenod@hcuge.ch</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</aff>
<aff id="I2"><label>2</label>
Department of Surgery, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</aff>
<aff id="I3"><label>3</label>
Division of Urology, Geneva University Hospitals and Medical School, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Geneva, Switzerland</aff>
<pub-date pub-type="collection"><year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>23</day>
<month>12</month>
<year>2012</year>
</pub-date>
<volume>12</volume>
<fpage>26</fpage>
<lpage>26</lpage>
<history><date date-type="received"><day>25</day>
<month>9</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>22</day>
<month>12</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>Copyright ©2012 Meyer Ganz et al.; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2012</copyright-year>
<copyright-holder>Meyer Ganz et al.; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.biomedcentral.com/1471-2482/12/26"></self-uri>
<abstract><sec><title>Background</title>
<p>Fournier’s gangrene is a bacterial infection characterized by necrotizing fasciitis, skin and soft tissue involvement, and eventually myositis of the perineal region. Aggressive debridement of devitalized tissue and overlying skin is of paramount importance, but often leaves large defects to be reconstructed. The present case reports successful extensive perineal defects coverage following Fournier’s gangrene and management of subsequent penile lymphoedema impairing sexual function in a young patient.</p>
</sec>
<sec><title>Case presentation</title>
<p>Following perianal abscess drainage, a healthy young man presented with scrotal pain. Fournier’s gangrene was diagnosed and treated with multiple surgical debridements. Tissue excision extended through the entire perineal area, base of the penile shaft, lower abdominal region, the inner thighs, and gluteal region, corresponding to 12% of the total body surface area. After serial debridements and negative pressure dressings, the defect was covered by two stages of skin grafting. Graft take was 90%. Healing was achieved without hypertrophic or retractile scar. However, chronic penile lymphedema remained and was first treated with compressive garments for 2 years. Upon failure of this conservative approach, we performed a circumcision, but only a “penile lift” allowed a satisfactory esthetical and functional result.</p>
</sec>
<sec><title>Conclusion</title>
<p>Fournier’s gangrene can be complicated by a chronic lymphedema of the penis. Conservative treatment is likely to fail in severe cases and can be treated surgically by “penile lift”.</p>
</sec>
</abstract>
<kwd-group><kwd>Fournier’s gangrene</kwd>
<kwd>Penile lymphedema</kwd>
<kwd>Negative pressure wound therapy</kwd>
<kwd>Perineal reconstruction</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001F18 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd -nk 001F18 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= LymphedemaV1 |flux= Pmc |étape= Curation |type= RBID |clé= PMC:3543169 |texte= Management of unusual genital lymphedema complication after Fournier’s gangrene: a case report }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Curation/RBID.i -Sk "pubmed:23259537" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd \ | NlmPubMed2Wicri -a LymphedemaV1
![]() | This area was generated with Dilib version V0.6.31. | ![]() |