Lymphatico-venous anastomosis in chronic ulcer with venous insufficiency: A case report.
Journal
Microsurgery
ISSN: 1098-2752
Titre abrégé: Microsurgery
Pays: United States
ID NLM: 8309230
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
revised:
08
02
2021
received:
29
07
2020
accepted:
06
05
2021
pubmed:
16
5
2021
medline:
8
9
2021
entrez:
15
5
2021
Statut:
ppublish
Résumé
Patients presenting with chronic wounds in venous insufficiency often represent a challenge, like other conditions, like lymphatic impairment, may complicate the wound healing process. The purpose of this report is to highlight how the treatment of lymphatic impairment may be beneficial in patients affected by chronic ulcers with concomitant venous insufficiency. We present the case of a 78-year-old woman affected by chronic venous insufficiency (CVI) with long-lasting ulcers secondary to sclerosing agents treatment for varicose veins. The patient's condition was refractory to both conservative and surgical treatment. Since the patient also presented with severe lymphorrhea, with a significant amount of daily secretion, ICG-lymphography was performed subcutaneously, to visualize the pathway of lymphatic drainage and leakage. It also allowed marking on the skin the exact location of lymphatic vessels distally to the wound area. Hence, two lymphatico-venous anastomoses were performed between the two major collecting lymphatic vessels and two subcutaneous veins of adequate size. The postoperative course was uneventful and the procedure allowed for immediate resolution of lymphatic leakage and complete wound healing within 2 weeks with no recurrence in the follow-up time of 1.5 years. Based on the outcomes of this case, it is possible to consider the use of CVI treatment and lymphedema surgery as a combined approach to complicated cases of long-standing venous ulcers with lymphorrhea.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
574-578Informations de copyright
© 2021 Wiley Periodicals LLC.
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