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Platysma-sparing vascularized submental lymph node flap transfer for extremity lymphedema
Igor Poccia1, Chia-Yu Lin1, Ming-Huei Cheng1,2
1Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Journal of Surgical Oncology
|January 7, 2017
Summary
A new platysma-sparing technique for submental lymph node flaps significantly reduces donor site morbidity in lymphedema treatment, preserving nerve and muscle function without compromising flap survival.
Area of Science:
- Microsurgery
- Plastic Surgery
- Lymphedema Management
Background:
- Vascularized submental lymph node flap is a reliable treatment for lymphedema.
- Standard flap harvest requires platysma resection, risking marginal mandibular nerve pseudo-paralysis.
- Donor site morbidity is a concern in submental lymph node flap transfer.
Purpose of the Study:
- To investigate the donor site morbidity of an innovative platysma-sparing vascularized submental lymph node flap.
- To compare the platysma-sparing technique with the standard submental lymph node flap harvest.
Main Methods:
- Prospective enrollment of 10 patients undergoing platysma-sparing submental lymph node flap harvest.
- Comparison with a control group of 10 patients who underwent standard harvest.
- Photogrammetry analysis to assess marginal mandibular nerve pseudo-paralysis at the donor site.
Main Results:
- All flaps survived with no skin paddle necrosis in both groups.
- No marginal mandibular nerve palsies were observed in either group.
- The platysma-sparing group showed no cases of marginal mandibular nerve pseudo-paralysis.
Conclusions:
- The platysma-sparing submental flap offers comparable functional improvement for extremity lymphedema.
- This technique maximizes nerve and muscular preservation.
- Significantly reduces donor site morbidity compared to the standard approach.
