Scar lymphedema: fact or fiction?
Identifieur interne : 003606 ( PubMed/Curation ); précédent : 003605; suivant : 003607Scar lymphedema: fact or fiction?
Auteurs : Anne G. Warren [États-Unis] ; Sumner A. SlavinSource :
- Annals of plastic surgery [ 0148-7043 ] ; 2007.
Descripteurs français
- KwdFr :
- MESH :
- épidémiologie : Cicatrice, Lymphoedème.
- Adolescent, Adulte, Adulte d'âge moyen, Face, Femelle, Humains, Lymphoedème, Mâle, Paroi abdominale, Paroi thoracique, Réintervention, Sujet âgé.
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
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Warren</name><affiliation wicri:level="1"><nlm:affiliation>Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Boston, MA</wicri:regionArea></affiliation></author><author><name sortKey="Slavin, Sumner A" sort="Slavin, Sumner A" uniqKey="Slavin S" first="Sumner A" last="Slavin">Sumner A. Slavin</name></author></analytic><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></biblStruct></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="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Cicatrice (épidémiologie)</term><term>Face</term><term>Femelle</term><term>Humains</term><term>Lymphoedème ()</term><term>Lymphoedème (épidémiologie)</term><term>Mâle</term><term>Paroi abdominale</term><term>Paroi thoracique</term><term>Réintervention</term><term>Sujet âgé</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" qualifier="épidémiologie" xml:lang="fr"><term>Cicatrice</term><term>Lymphoedème</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></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Face</term><term>Femelle</term><term>Humains</term><term>Lymphoedème</term><term>Mâle</term><term>Paroi abdominale</term><term>Paroi thoracique</term><term>Réintervention</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><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></PublicationTypeList></Article><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><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2007</Year><Month>6</Month><Day>26</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2007</Year><Month>9</Month><Day>26</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2007</Year><Month>6</Month><Day>26</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">17589258</ArticleId><ArticleId IdType="doi">10.1097/01.sap.0000258449.23979.3f</ArticleId><ArticleId IdType="pii">00000637-200707000-00009</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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