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Modified Charles procedure and lymph node flap transfer for advanced lower extremity lymphedema
Stamatis Sapountzis1, Pedro Ciudad, Seong Yoon Lim
1Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan.
Microsurgery
|March 29, 2014
Summary
This study shows that combining a modified Charles procedure with lymph node flap transfer effectively treats advanced lymphedema. Patients experienced significant limb volume reduction and returned to normal activities with no recurrence during follow-up.
Area of Science:
- Reconstructive Surgery
- Lymphedema Management
- Microsurgery
Background:
- Advanced lymphedema treatment remains challenging.
- Microsurgical techniques are less established in advanced stages.
- A novel approach combining excisional surgery and lymph node flap transfer is presented.
Purpose of the Study:
- To evaluate the efficacy of a novel surgical technique for advanced lymphedema.
- To assess the outcomes of combining a modified Charles procedure with lymph node flap transfer.
Main Methods:
- 24 patients with late-stage lower extremity lymphedema underwent the procedure.
- The modified Charles procedure involved preserving specific venous systems for anastomosis.
- Inguinal or supraclavicular lymph node flaps were transferred.
Main Results:
- Significant reduction in lymphedema was achieved.
- No major complications occurred; minor skin graft loss required re-grafting in two patients.
- All lymph node flaps survived, and patients resumed normal activities within 2 months.
Conclusions:
- The combined modified Charles procedure and lymph node flap transfer is effective for advanced lymphedema.
- This technique offers a viable solution for challenging lymphedema cases.
- The procedure demonstrated good long-term outcomes with no recurrence observed.
