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Related Experiment Videos

Charles procedure for lymphedema: a warning

T A Miller

    American Journal of Surgery
    |February 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

    Split-thickness grafts for lower extremity lymphedema led to poor outcomes, including amputation. Staged subcutaneous excision with flaps offers a safer, more effective alternative for managing lymphedema.

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    Area of Science:

    • Plastic Surgery
    • Lymphedema Management
    • Reconstructive Surgery

    Background:

    • Lower extremity lymphedema presents significant challenges in management.
    • Previous surgical interventions, such as split-thickness grafting, have shown suboptimal results.

    Purpose of the Study:

    • To evaluate the efficacy of split-thickness grafting versus alternative surgical techniques for lower extremity lymphedema.
    • To compare outcomes of different surgical approaches for lymphedema treatment.

    Main Methods:

    • Review of five patients treated with subcutaneous excision and split-thickness grafts.
    • Analysis of outcomes including amputation, chronic cellulitis, and skin breakdown.
    • Comparison with the Charles procedure (subcutaneous and deep fascial excision with full-thickness grafts).

    Related Experiment Videos

  • Evaluation of staged subcutaneous excision beneath flaps over a 9-year period.

    • Main Results:

    • Three out of five patients treated with split-thickness grafts required amputation due to complications.
    • Split-thickness grafting resulted in deformities worse than the original lymphedema.
    • Staged subcutaneous excision with flaps successfully treated 25 patients, yielding size reduction, functional improvement, and aesthetic results.

    Conclusions:

    • Split-thickness grafting is not recommended for lower extremity lymphedema due to high complication rates.
    • The Charles procedure, with modifications for durable full-thickness grafts, is a viable option.
    • Staged subcutaneous excision beneath flaps is a preferred method for consistent, safe, and effective lymphedema management.