Delayed primary retention suture for inset of vascularized submental lymph node flap for lower extremity lymphedema

Satomi Koide, Chia Yu Lin, Ming Huei Cheng*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

10 Scopus citations

Abstract

Background: Vascularized lymph node transfer (VLNT) has become one of the effective surgical treatments for extremity lymphedema. This study was to evaluate the re-exploration and total complication rates of VLNT for lower extremity lymphedema between two different flap inset techniques. Methods: Sixty-nine patients who underwent 74 submental VLNT transfers between 2008 and 2018 were retrospectively studied. Fifty-six flaps were inset using a new delayed primary retention suture (DPRS) technique and other 18 flaps using conventional interrupted sutures as the non-DPRS group. Results: The overall flap success rate was 100%. The DPRS group was released at a mean of 1.7 ± 0.7 times and took a mean of 10.3 ± 3.3 days for wound closure. There were no statistical differences in demographics, mean symptom duration, and mean Cheng's Lymphedema Grading between two groups. Mean frequency of cellulitis of 2.5 ± 1.5 times/year in non-DPRS group was significantly greater than 1.4 ± 1.6 times/year in DPRS group (P =.01). The re-exploration and total complication rates were 5.4% and 7.1% in DPRS group, and 27.8% and 33.3% in non-DPRS group, respectively (P =.02 and.02, respectively). Conclusions: The DPRS technique is a safe, simple, and reliable method for insetting the submental VLNT, which statistically decreased the re-exploration and total complication rates.

Original languageEnglish
Pages (from-to)138-143
Number of pages6
JournalJournal of Surgical Oncology
Volume121
Issue number1
DOIs
StatePublished - 01 01 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.

Keywords

  • lymphedema
  • microsurgery
  • re-exploration
  • submental flap
  • vascularized lymph node transfer
  • venous complication

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