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Lymphaticovenular anastomosis for recurrent cellulitis in a dementia patient with lymphedema

Shuhei Yoshida1, Isao Koshima1, Hirofumi Imai1

  • 1International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan.

Journal of Vascular Surgery Cases and Innovative Techniques
|July 28, 2020
PubMed

Insights

A dementia patient with recurrent cellulitis and lymphedema found relief through lymphaticovenular anastomosis (LVA). This surgical treatment prevented cellulitis recurrence for two years, offering a new option for patients unable to undergo compression therapy.

Area of Science:

  • Vascular Surgery
  • Lymphedema Management
  • Geriatric Medicine

Background:

  • Recurrent cellulitis is a common complication of chronic lymphedema.
  • Managing lymphedema and its complications in elderly patients, especially those with cognitive impairment like dementia, presents unique challenges.
  • Compression therapy, a standard treatment for lymphedema, is often difficult to implement in patients with dementia.

Observation:

  • An 83-year-old female patient with dementia experienced recurrent cellulitis (average 3 times/year for 15 years) in her left lower limb, complicated by lymphedema.
  • Traditional compression therapy was not feasible due to the patient's dementia.
  • The patient underwent lymphaticovenular anastomosis (LVA) to address the underlying lymphedema.

Findings:

  • Following LVA, the patient has remained free from cellulitis recurrence for a two-year period.
  • Lymphaticovenular anastomosis (LVA) proved effective in managing recurrent cellulitis in this specific patient cohort.
  • The study highlights the successful application of LVA in a challenging clinical scenario.

Implications:

  • Lymphaticovenular anastomosis (LVA) offers a promising alternative treatment for recurrent cellulitis in dementia patients with lymphedema.
  • This approach may overcome limitations associated with traditional decongestive lymphatic therapy in patients with cognitive impairment.
  • Further research into LVA for complex lymphedema cases in elderly populations is warranted.

Keywords:
CellulitisDementiaLymphaticovenular anastomosisLymphedema

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