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Updates on Excisional Procedures for Lymphedema
Stephen L Viviano1, Peter C Neligan1
1Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA.
Advances in Wound Care
|June 15, 2021
Summary
Excisional surgery remains a key treatment for lymphedema, with recent advances improving outcomes. Further research is needed to establish optimal protocols for combining surgical techniques in lymphedema management.
Area of Science:
- Surgical Oncology
- Vascular Surgery
- Lymphedema Management
Background:
- Excisional procedures for lymphedema have a long history.
- Their utility has been questioned due to advances in conservative and microsurgical treatments.
- However, excisional techniques remain a vital component of comprehensive lymphedema care.
Purpose of the Study:
- To review recent advances in excisional lymphedema surgery.
- To discuss critical issues in patient selection and management protocols.
- To outline future research directions for optimizing surgical outcomes.
Main Methods:
- Review of modifications to established excisional procedures (e.g., Charles procedure).
- Inclusion of minimally invasive techniques like liposuction for tissue excision.
- Exploration of combined excisional and physiologic procedures.
Main Results:
- Modified excisional procedures show improved complication rates and patient outcomes.
- Liposuction expands surgical options for less severe lymphedema.
- Combined approaches may offer superior results compared to standalone methods.
Conclusions:
- Despite historical context, excisional surgery is crucial for lymphedema.
- Standardized protocols and careful patient selection are essential.
- Future prospective trials are necessary to determine optimal timing and combinations of techniques for advanced lymphedema.
