Vascularized Free Lymph Node Flap Transfer in Advanced Lymphedema Patient after Axillary Lymph Node Dissection

Area of Science:

• Plastic Surgery
• Microsurgery
• Lymphedema Management

Background:

• Lymphedema, particularly advanced stages (IIIb, IVa, IVb), presents significant challenges in reconstructive surgery due to irreversible fibrosis and edema.
• Current microvascular techniques like lymphaticovenous anastomosis and vascularized lymph node transfer show efficacy in early-stage lymphedema.

Observation:

• A novel two-stage surgical approach was employed for a patient with advanced lymphedema.
• The first stage involved a debulking procedure using liposuction.
• The second stage, performed 10 weeks later, consisted of a vascularized free lymph node flap transfer.

Findings:

• The two-stage surgical intervention yielded positive outcomes in the advanced lymphedema patient.
• Significant reductions in upper extremity circumferences were observed immediately following the surgical procedures.

Implications:

• This two-stage approach offers a promising reconstructive strategy for managing advanced lymphedema.
• The combination of debulking and lymph node transfer may improve outcomes for complex lymphedema cases.
• Further research is warranted to validate this technique in a broader patient population.