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Post-traumatic massive hand lymphedema fully cured by vascularized lymph node flap transfer.

Corinne Becker1, Lionel Arrivé2, Giuseppe Mangiameli1

  • 1Department of Thoracic Surgery and Lung Transplantation, Paris Descartes University, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France.

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This study presents a novel surgical approach for massive post-traumatic hand lymphedema. Vascularized lymph node flap transfer combined with dermolipectomy successfully restored lymphatic flow and cured patients.

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Area of Science:

  • Medicine
  • Surgery
  • Lymphedema Management

Background:

  • Post-traumatic hand lymphedema is rare and challenging to diagnose.
  • Delayed diagnosis can lead to inappropriate treatments and significant psychosocial distress.

Purpose of the Study:

  • To investigate the efficacy of a combined surgical approach for massive post-traumatic hand lymphedema.
  • To highlight the diagnostic challenges and treatment failures in such cases.

Main Methods:

  • Noncontrast magnetic resonance lymphography to diagnose lymphatic vessel blockage.
  • Local dermolipectomy followed by vascularized lymph node flap transfer from the groin to the elbow.

Main Results:

  • Magnetic resonance lymphography confirmed complete lymphatic blockage in both patients.
  • The surgical intervention successfully restored lymphatic flow.
  • Both patients achieved a complete cure and returned to normal activities within six months.

Conclusions:

  • Lymph node flap transfer with dermolipectomy is a viable treatment for selected cases of massive localized lymphedema.
  • Early and accurate diagnosis is crucial for effective lymphedema management.