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44. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen e. V. (DGPRÄC), 18. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen e. V. (VDÄPC)

12.09. - 14.09.2013, Münster

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The Mechanism of Vascularized Lymph Node Transfer for Lymphedema – Natural Lymphatico-Venous Drainage

Meeting Abstract

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  • presenting/speaker Leila Kolios - BG Unfallklinik Ludwigshafen, Hand-, Plastische und Wiederherstellungschirurgie, Schwerbrandverletztenzentrum, Klinik fuer Plastische Chirurgie der Universitaet Heidelberg, Ludwigshafen, Deutschland
  • Jung-Ju Huang - Chang Gung Memorial Hospital, Department of Plastic and Reconstructive Surgery, Taipei, Taiwan, Taiwan
  • Jerry Wu - Chang Gung Memorial Hospital, Department of Plastic and Reconstructive Surgery, Taipei, Taiwan, Taiwan
  • Chia-Yui Yang - Chang Gung Memorial Hospital, Department of Plastic and Reconstructive Surgery, Taipei, Taiwan, Deutschland
  • Chia-Yu Lin - Chang Gung Memorial Hospital, Department of Plastic and Reconstructive Surgery, Taipei, Taiwan, Taiwan
  • Ulrich Kneser - BG Unfallklinik Ludwigshafen, Hand-, Plastische und Wiederherstellungschirurgie, Schwerbrandverletztenzentrum, Klinik fuer Plastische Chirurgie der Universitaet Heidelberg, Ludwigshafen, Deutschland
  • Ming-Huei Cheng - Chang Gung Memorial Hospital, Department of Plastic and Reconstructive Surgery, Taipei, Taiwan, Taiwan

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 44. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 17. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Münster, 12.-14.09.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocFV 29

doi: 10.3205/13dgpraec036, urn:nbn:de:0183-13dgpraec0369

Veröffentlicht: 10. September 2013

© 2013 Kolios et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

Purpose: Transfer of vascularized lymph node flaps for treatment of postoperative and postradiation lymphedema is a relatively new, but encouraging method. The purpose was to investigate the mechanism and potency of lymph drainage of these flaps.

Materials and Methods: Indocyanine green fluorescence imaging was used to inject fluorescent dye either into subcutaneous soft tissue (Rat-sc group) or directly into lymph node (Rat-LN group) of each 12 adipous groin lymph node flaps in 3-month-old SD rats. 12 adipocutaneous non-lymph node containing DIEP flaps (Rat-NLN group) were injected as negative control. In clinical part vascularized submental lymph node flaps were accordingly injected either in subcutaneous soft tissue (Clin-sc group) or lymph node directly (Clin-LN group) and non-lymph node containing ALT and forearm flaps were used as negative control (Clin-NLN group).

Results: All LN containing flaps in experimental and clinical groups showed drainage of the ICG dye via the pedicle vein. Detection in Rat-LN group with 12.8±8.1 sec (±SD) and Clin-LN group with 23.7±28.9 sec (±SD) was significantly earlier than in corresponding Rat-SC group with 147.3±133.7 sec (±SD) and Clin-SC group with 500±494.5 sec (±SD). In Rat-NLN group and Clin-NLN groups there was no drainage of the dye over the pedicle veins.

Discussion: The findings of animal as well as clinical part of the study verify the mechanism of lymphatico-venous drainage as potent in vascularized lymph node flaps for transporting interstitial lymphedema fluid into venous system. This supports the already reported positive clinical outcome results of this operation method.