Lymphœdèmes primaires des membres

Vaillant, L.; Tauveron, Valérie

doi:10.1016/j.lpm.2010.09.010

Cited by 6 publications

(2 citation statements)

References 37 publications

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“…Our observations outline a rational theoretical basis toward which a broader clinical use of skin substitutes in lesions when the risk of lymphedema would compromise both morphological and functional outcomes. [ 51 52 53 54 ] Although further studies are necessary in order to better evaluate the development of the lymphatic network in more evolved models, such as porcine or human models, this study represents a rational start in our understanding of the reasons why ADMs have so many useful applications in plastic and reconstructive surgery.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of lymphangiogenesis in acellular dermal matrix

Cherubino

Pellegatta

Tamborini

et al. 2014

Indian J Plast Surg

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Introduction:Much attention has been directed towards understanding the phenomena of angiogenesis and lymphangiogenesis in wound healing. Thanks to the manifold dermal substitute available nowadays, wound treatment has improved greatly. Many studies have been published about angiogenesis and cell invasion in INTEGRA®. On the other hand, the development of the lymphatic network in acellular dermal matrix (ADM) is a more obscure matter. In this article, we aim to characterize the different phases of host cell invasion in ADM. Special attention was given to lymphangiogenic aspects.Materials and Methods:Among 57 rats selected to analyse the role of ADM in lymphangiogenesis, we created four groups. We performed an excision procedure on both thighs of these rats: On the left one we did not perform any action except repairing the borders of the wound; while on the right one we used INTEGRA® implant. The excision biopsy was performed at four different times: First group after 7 days, second after 14 days, third after 21 days and fourth after 28 days. For our microscopic evaluation, we used the classical staining technique of haematoxylin and eosin and a semi-quantitative method in order to evaluate cellularity counts. To assess angiogenesis and lymphangiogenesis development we employed PROX-1 Ab and CD31/PECAM for immunohistochemical analysis.Results:We found remarkable wound contraction in defects that healed by secondary intention while minor wound contraction was observed in defects treated with ADM. At day 7, optical microscopy revealed a more plentiful cellularity in the granulation tissue compared with the dermal regeneration matrix. The immunohistochemical process highlighted vascular and lymphatic cells in both groups. After 14 days a high grade of fibrosis was noticeable in the non-treated group. At day 21, both lymphatic and vascular endothelial cells were better developed in the group with a dermal matrix application. At day 28, lymphatic endothelial cells had organized themselves, engineering the pseudocylindrical structure better disposed in the ADM group than in the control group, and the lymphatic cells were detectable inside the vessels’ lumen in this group.Conclusion:This study has made it possible to demonstrate the absolute importance of an ADM in proper wound healing and has shown better definition of both the qualitative and quantitative aspects of lymphangiogenesis compared to the second intention healing. A major grade of organization of the extracellular matrix and a minor grade of fibrosclerosis in ADM allowed a well-structured morphologic and functional development of the endothelial and lymphatic vascular structures. This study hopes to represent a clinical basis for a wider use of ADM in lesions where lymphatic complications are common.

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Section: Discussionmentioning

confidence: 99%

Evaluation of lymphangiogenesis in acellular dermal matrix

Cherubino

Pellegatta

Tamborini

et al. 2014

Indian J Plast Surg

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“…Lymphedema is a chronic condition due to impaired lymphatic fluid return resulting in swelling, pain, tissue fibrosis, and skin changes. 1 This can be a debilitating disease and affects the quality of life of one in 1,000 people in the United States and globally; there are 250 million people that have developed lymphedema. 2 In the past, there were several extirpative procedures used to treat lymphedema, such as staged excision (modified Homan's procedure) and excision followed by a skin graft (Charles' procedure).…”

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confidence: 99%

The Top 100 Cited Articles in the Microsurgical Treatment for Lymphedema

Cordero

Eidelson

Frediani

et al. 2022

J Reconstr Microsurg

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Background: Evidence-based medicine uses the current best evidence for decisions about patient care. Lymphedema is a chronic debilitating medical condition caused by a dysfunctional lymphatic system. This study analyzes the most cited articles, including the levels of evidence, for the surgical treatment of lymphedema. Methods: The Web of Science Sci-Expanded Index was utilized to search for surgical treatment of lymphedema. Articles were examined by three independent reviewers and the top 100 articles were determined. The corresponding author, citation count, publication year, topic, study design, level of evidence, journal, country, and institution were analyzed. Results: Since 1970, the top 100 articles have been cited 7,300 times. The average citation count was 68 and standard deviation was 55. The majority were case series (71), followed by retrospective cohort (8), prospective cohort (7), retrospective case-control (5), and randomized controlled trials (2). Based on the “Level of Evidence Pyramid”, 71 articles were level IV, 13 articles were level III, and 9 articles were level II. On the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Scale, there were 71 articles with “very low,” 20 articles with “low,” and 2 articles with “moderate” quality of evidence. Conclusion: The top 100 cited articles were mostly case series and lacked high levels of evidence. Most studies are retrospective case series with short-term outcomes. However, low level evidence for new surgical procedures is to be expected. Current trends suggest the treatment and understanding of lymphedema will continue to improve.

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