Platysma-sparing vascularized submental lymph node flap transfer for extremity lymphedema

Background and Objectives: Due to its consistent vascular and lymphatic anatomy, the vascularized submental lymph node flap is a reliable option for lymphedema treatment. Despite these advantages, flap harvest requires resection of platysma, which may cause a marginal mandibular nerve pseudo-paralysis. The aim of this study was to investigate the donor site morbidity of an innovative platysma-sparing vascularized submental lymph node flap transfer for treating extremity lymphedema. Methods: Ten patients undergoing platysma sparing submental lymph-node flap harvest were prospectively enrolled in the study and compared with a control group of 10 patients who underwent standard submental lymph-node flap harvest. Photogrammetry analysis was used to assess donor site morbidity with regards to marginal mandibular nerve pseudo-paralysis. Results: All flaps survived. No necrosis of the skin paddle was observed in both groups. There were no marginal mandibular nerve palsies in both group. There were no cases of marginal mandibular nerve pseudo-paralysis in the platysma sparing group. Conclusions: The platysma sparing submental flap, while offering comparable functional improvement for extremity lymphedema, has the advantages of maximizing nerve and muscular preservation, significantly reducing donor site morbidity. J. Surg. Oncol. 2017;115:48–53.