Post-traumatic lymphedema: review of the literature and surgical treatment options

Minasian, Raquel A.; Samaha, Yasmina; Brazio, Philip S.

doi:10.20517/2347-9264.2021.128

Cited by 3 publications

(4 citation statements)

References 32 publications

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“…19,20 Posttraumatic extremity lymphedema incidence is unknown and the problem is underdiagnosed. 26 It is demonstrated that after limb trauma, even without physical disruption of the superficial lymphatic system, 100% of the patients can experience edema due to increased lymphatic production from local inflammation, which is thought to be a contributing mechanism. There is a group of patients in which the edema resolves spontaneously, probably due to a remitted inflammatory process rather than resolved lymphatic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

A Comprehensive Approach to Posttraumatic Lymphedema Surgical Treatment

2023

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Background Posttraumatic lymphedema (PTL) is sparsely described in the literature. The aim of this study is to propose a comprehensive approach for prevention and treatment of PTL using lymphovenous anastomosis (LVA) and lymphatic vessels free flap, reporting our experience in the management of early-stage lymphedema. Methods A retrospective observational study was performed between October 2017 and July 2022. Functional assessment with magnetic resonance lymphangiography and indocyanine green lymphography was performed. Patients with lymphedema and functional lymphatic channels were included. Cases with limited soft tissue damage were proposed for LVA, and those with acute or prior soft tissue damage needing skin reconstruction were proposed for superficial circumflex iliac artery perforator lymphatic vessels free flap (SCIP-LV) to treat or prevent lymphedema. Primary and secondary outcomes were limb volume reduction and quality of life (QoL) improvement, respectively. Follow-up was at least 1 year. Results Twenty-eight patients were operated using this approach during the study period. LVA were performed in 12 patients; mean reduction of excess volume (REV) was 58.82% and the improvement in QoL was 49.25%. SCIP-LV was performed in seven patients with no flap failure; mean REV was 58.77% and the improvement QoL was 50.9%. Nine patients with acute injury in lymphatic critical areas were reconstructed with SCIP-LV as a preventive approach and no lymphedema was detected. Conclusion Our comprehensive approach provides an organized way to treat patients with PTL, or at risk of developing it, to have satisfactory results and improve their QoL.

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Section: Discussionmentioning

confidence: 99%

A Comprehensive Approach to Posttraumatic Lymphedema Surgical Treatment

2023

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“…Another common cause of secondary lymphedema in humans is post-traumatic lymphedema [ 28 ]. The majority of reported cases describe a fracture as initiating event, but also burns, penetrating, and blunt injuries, resulting in the disruption of the cisterna chyli, thoracic duct, or other regions of increased density of lymphatic vessels, e.g., extremities are reported.…”

Section: Discussionmentioning

confidence: 99%

“…In our case, there was neither prior history of trauma, nor clinical findings, suggesting a previous injury. These data, together with the results of indirect CT lymphography of the patient and the fact that minor trauma rarely leads to chronic lymphedema, make this mechanism of development of lymphedema in this dog highly unlikely [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Presumptive Primary Lymphedema Localized to the Face of a Dog

Poláková,

Lederer,

Richter

et al. 2023

Veterinary Sciences

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Primary lymphedema (PLE) is an uncommon diagnosis in veterinary medicine, with most of the previously described cases showing lower limb edema associated with a guarded long-term prognosis. To the authors’ knowledge, this case report describes the first case of lymphedema localized unilaterally to the facial region of one-year-old German Shorthair Pointer, in which indirect CT-lymphography, combined with histopathologic examination of the skin, resulted in a tentative diagnosis of PLE.

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“…Anatomically, most peripheral superficial lymphatic vessels of the lower leg run along the way of the medial face of the limb, parallel to the superficial great saphenous vein [21] damage, chronic inflammation, and trauma to this specific anatomic area contribute to the development of secondary lower limb lymphedema [22][23][24][25][26]. This site was exactly the spider bite site, where local loxoscelism was developed, where the skin and soft tissue destruction happened to be; the epicenter of the chronic inflammatory process caused by the wound, and where recurrent lymphangitis originated.…”

Section: Fig 3 Wound Detail Note the Broad Rings Of Fibrous And Devit...mentioning

confidence: 99%

Lymphedema as Consequence of Loxosceles Brown Spider Bite: A Case Report and Literature Review

López-Montoya¹,

Zarate-Sánchez

Saenz-Ramirez

et al. 2022

IJTDH

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Introduction: Secondary lymphedema is defined as a chronic-progressive disease that causes rich protein edema of the limbs, this may be caused due to the damage or obstruction of lymphatic structures; complications associated with loxosceles spider bite may cause damage to the lymphatic system. Objective: To describe the clinical case of a patient with lower extremity lymphedema secondary to loxosceles' spider bite complications and to present a literature review on the topic. Case Presentation: A 24-year-old man received previous medical attention between 2020-and 2021 due to complications of a loxosceles brown spider bite. He arrived at our facilities in January 2022 to assess his case related to progressive volume leg increase and a chronic wound in the bitten site. After the clinical history analysis, physical examination, and a near-infrared lymphography study of the leg, damage to lymphatic structures was identified; secondary lymphedema was confirmed. It was possible to reverse and control the lymphedema volume and the wound evolved to complete closure. The case is presented along with a literature review on the topic. Conclusion: It is presented a case of lymphedema associated with a loxosceles brown spider bite, and successfully treated. Lymphedema related to a loxosceles spider bite and its complications is a clinical reality that might be underrecognized by scientific literature and clinicians; this condition should be properly studied and considered with adequate assessment strategies in patients after suffering the spider bite in extremities, especially in the mid and long-term.

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Post-traumatic lymphedema: review of the literature and surgical treatment options

Cited by 3 publications

References 32 publications

A Comprehensive Approach to Posttraumatic Lymphedema Surgical Treatment

A Comprehensive Approach to Posttraumatic Lymphedema Surgical Treatment

A Case Report of Presumptive Primary Lymphedema Localized to the Face of a Dog

Lymphedema as Consequence of Loxosceles Brown Spider Bite: A Case Report and Literature Review

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