Scar lymphedema: fact or fiction?
Identifieur interne : 003606 ( PubMed/Corpus ); précédent : 003605; suivant : 003607Scar lymphedema: fact or fiction?
Auteurs : Anne G. Warren ; Sumner A. SlavinSource :
- Annals of plastic surgery [ 0148-7043 ] ; 2007.
English descriptors
- KwdEn :
- MESH :
- epidemiology : Cicatrix, Lymphedema.
- surgery : Lymphedema.
- Abdominal Wall, Adolescent, Adult, Aged, Face, Female, Humans, Male, Middle Aged, Reoperation, Thoracic Wall.
Abstract
Few concepts are as fundamental to plastic surgery as scarring, yet swelling within a scar and its adjacent tissues is a common observation which is not well understood. Mechanical forces, scar contracture, fibrosis, and lymph stasis have been considered as possible explanations for these edematous-appearing areas, but conclusive evidence of a cause of swelling has not been established. The purpose of this study was to evaluate the possible role of microlymphatic stasis or disruption as a causal factor.
DOI: 10.1097/01.sap.0000258449.23979.3f
PubMed: 17589258
Links to Exploration step
pubmed:17589258Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Scar lymphedema: fact or fiction?</title>
<author><name sortKey="Warren, Anne G" sort="Warren, Anne G" uniqKey="Warren A" first="Anne G" last="Warren">Anne G. Warren</name>
<affiliation><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Slavin, Sumner A" sort="Slavin, Sumner A" uniqKey="Slavin S" first="Sumner A" last="Slavin">Sumner A. Slavin</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Scar lymphedema: fact or fiction?</title>
<author><name sortKey="Warren, Anne G" sort="Warren, Anne G" uniqKey="Warren A" first="Anne G" last="Warren">Anne G. Warren</name>
<affiliation><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation>
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<author><name sortKey="Slavin, Sumner A" sort="Slavin, Sumner A" uniqKey="Slavin S" first="Sumner A" last="Slavin">Sumner A. Slavin</name>
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<series><title level="j">Annals of plastic surgery</title>
<idno type="ISSN">0148-7043</idno>
<imprint><date when="2007" type="published">2007</date>
</imprint>
</series>
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</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Abdominal Wall</term>
<term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Cicatrix (epidemiology)</term>
<term>Face</term>
<term>Female</term>
<term>Humans</term>
<term>Lymphedema (epidemiology)</term>
<term>Lymphedema (surgery)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Reoperation</term>
<term>Thoracic Wall</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Cicatrix</term>
<term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Abdominal Wall</term>
<term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Face</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Reoperation</term>
<term>Thoracic Wall</term>
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<front><div type="abstract" xml:lang="en">Few concepts are as fundamental to plastic surgery as scarring, yet swelling within a scar and its adjacent tissues is a common observation which is not well understood. Mechanical forces, scar contracture, fibrosis, and lymph stasis have been considered as possible explanations for these edematous-appearing areas, but conclusive evidence of a cause of swelling has not been established. The purpose of this study was to evaluate the possible role of microlymphatic stasis or disruption as a causal factor.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">17589258</PMID>
<DateCreated><Year>2007</Year>
<Month>06</Month>
<Day>25</Day>
</DateCreated>
<DateCompleted><Year>2007</Year>
<Month>09</Month>
<Day>25</Day>
</DateCompleted>
<DateRevised><Year>2007</Year>
<Month>06</Month>
<Day>25</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Print">0148-7043</ISSN>
<JournalIssue CitedMedium="Print"><Volume>59</Volume>
<Issue>1</Issue>
<PubDate><Year>2007</Year>
<Month>Jul</Month>
</PubDate>
</JournalIssue>
<Title>Annals of plastic surgery</Title>
<ISOAbbreviation>Ann Plast Surg</ISOAbbreviation>
</Journal>
<ArticleTitle>Scar lymphedema: fact or fiction?</ArticleTitle>
<Pagination><MedlinePgn>41-5</MedlinePgn>
</Pagination>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Few concepts are as fundamental to plastic surgery as scarring, yet swelling within a scar and its adjacent tissues is a common observation which is not well understood. Mechanical forces, scar contracture, fibrosis, and lymph stasis have been considered as possible explanations for these edematous-appearing areas, but conclusive evidence of a cause of swelling has not been established. The purpose of this study was to evaluate the possible role of microlymphatic stasis or disruption as a causal factor.</AbstractText>
<AbstractText Label="PATIENTS AND METHODS" NlmCategory="METHODS">Eleven patients (mean age: 43; range: 15 to 70) with localized swelling in conjunction with linear or curvilinear scars were evaluated, 9 with facial scars and 2 with scars of the chest wall and abdomen. Swelling within the scar had been present for an average of 4.5 years (range: 9 months to 13 years). Two patients had undergone previous Z-plasty revisions to the limbs of their curvilinear scars. Radiocolloid lymphoscintigraphy with technetium-99m Sb2S3 was performed on all patients by single or multiple injection technique into the site of the scar corresponding to local edema.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Following injection, rapid egress of radiotracer was visualized along lymphatic pathways posterior to the scar, with continuation to locoregional nodes in all patients with U-shaped "trapdoor" or linear scar configuration. However, in 8 cases there was no evidence of lymphatic drainage traversing or bridging the scar. In 2 patients with multiple prior Z-plasty revisions to the limbs of curvilinear scars, no visualization of lymph channels across the Z-plasty flaps was apparent. In total, 8 patients were diagnosed with lymphedema of the area adjacent to or enclosed within the scar.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">These findings suggest that undrained lymphatic fluid contributes to the pathogenesis of the raised and swollen tissues seen abutting a U-shaped scar. Furthermore, as lymphatic pathways do not reestablish themselves across scars, attempts at improving lymphatic flow with Z-plasty revisions may not succeed in patients with clinical trapdoor scar deformities. Determination of scar lymphedema can assist in the selection of proper management for patients seeking scar revision.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Warren</LastName>
<ForeName>Anne G</ForeName>
<Initials>AG</Initials>
<AffiliationInfo><Affiliation>Harvard Medical School, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Slavin</LastName>
<ForeName>Sumner A</ForeName>
<Initials>SA</Initials>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
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<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Ann Plast Surg</MedlineTA>
<NlmUniqueID>7805336</NlmUniqueID>
<ISSNLinking>0148-7043</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D034861" MajorTopicYN="N">Abdominal Wall</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002921" MajorTopicYN="N">Cicatrix</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005145" MajorTopicYN="N">Face</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
<QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012086" MajorTopicYN="N">Reoperation</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D035441" MajorTopicYN="N">Thoracic Wall</DescriptorName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
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<Month>6</Month>
<Day>26</Day>
<Hour>9</Hour>
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<PubMedPubDate PubStatus="medline"><Year>2007</Year>
<Month>9</Month>
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