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47. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 21. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

08.09. - 10.09.2016, Kassel

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An Integrative Therapeutic Concept for Surgical Treatment of Severe Cases of Lymphedema of the Lower Extremity

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  • presenting/speaker Jurij Kiefer - BG Unfallklinik Ludwigshafen, Plastische und Handchirurgie, Ludwigshafen, Deutschland; Universitätsklinikum Freiburg, Plastische und Handchirurgie, Freiburg, Deutschland
  • Georgios Koulaxouzidis - Universitätsklinikum Freiburg, Plastische und Handchirurgie, Freiburg, Deutschland
  • G. Björn Stark - Universitätsklinikum Freiburg, Plastische und Handchirurgie, Freiburg, Deutschland
  • Etelka Földi - Földi Klinik, Hinterzarten, Deutschland
  • Nestor Torio-Padron - Universitätsklinikum Freiburg, Plastische und Handchirurgie, Freiburg, Deutschland
  • Vincenzo Penna - Universitätsklinikum Freiburg, Plastische und Handchirurgie, Freiburg, Deutschland

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 47. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 21. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Kassel, 08.-10.09.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc074

doi: 10.3205/16dgpraec074, urn:nbn:de:0183-16dgpraec0744

Published: September 27, 2016

© 2016 Kiefer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background: Lymphedema results from insufficient lymphatic drainage and typically affects the extremities. Recent studies revealed obesity as another cause of extremity lymphedema. Conservative treatment of patients with elephantiastic lymphedema of the lower extremity is limited and often inadequate. Resecting surgery plays an important role in these cases. Here we investigated the effects of an integrated therapy concept on outcome and complication rates.

Methods: We retrospectively analyzed the clinical outcome of 26 patients with elephantiastic lymphedema of the lower limb who underwent a complex decongestive physical therapy (CDP) perioperatively and reduction surgery in our clinic between 1998 and 2011. We subsequently compared these patients (group A) with a control group of 30 patients (group B) who received medial thigh lift due to post-bariatric or aesthetic issues between 2011 and 2013. The incidence of complications, reoperations, blood transfusion, and duration of hospital stay were analyzed. All patients in group A received CDP perioperatively in a specialized lymphological clinic.

Results: Both groups are comparable in terms of age and sex. Patients significantly differ in terms of BMI (p=1.000) and the rate of postoperative blood transfusions (p=0.116).

Conclusions: We were able to show that an integrative concept including surgery is a good additional option for the treatment of severe cases of lymphedema in appropriate candidates. Furthermore, an adequate perioperative conservative setting helps to minimize possible complications.