Erysipelas as an aggravating factor for impaired lymphatics in saphenectomy patients.
BACKGROUND
The aim of this study was to evaluate lymphoscintigraphic changes in patients who developed erysipelas after saphenous vein stripping.


METHODS
Lymphoscintigraphic changes related to erysipelas were evaluated in a retrospective, cross-sectional and quantitative study of 21 saphenectomy patients. Patients with infections, those weighing over 120 kg, with chronic arterial disease or heart failure were excluded from the study. A control group was formed of 21 patients submitted to saphenectomies matched by age and gender but with no history of erysipelas. All patients underwent lymphoscintigraphy of both legs. The Fisher's Exact and χ2 tests were used for statistical analysis with an alpha error of 5% being considered acceptable.


RESULTS
Associations of dermal reflux and popliteal lymph nodes with erysipelas were observed in operated patients compared to non-operated patients (P value= 0.002 and 0.03, respectively). Semiquantitative analysis showed a variation in the Kleinhans transport indexes of 0.15 to 20.5 for the entire sample. Group I showed a mean semiquantitative index of 2.42 (0.3 to 14.5), group II of 3.15 (0.225 to 15.125) and group III of 10.2 (0.15 to 38.25). The comparison of semiquantitative indexes of the groups by χ2 analysis showed that there was a statistically significant difference between the first two groups (I and II) and group III (P value <0.05).


CONCLUSIONS
Erysipelas is a synergistic mechanism of injury of the lymphatic system in patients submitted to saphenectomies.
Department of Lymphovenous Rehabilitation, Medicine School of São Jose do Rio Preto, São Jose do Rio Preto, Brazil.
Cleusa E
CE
Quilici Belczak
Department of Cardiology and Cardiovascular Surgery, Medical School of São José do Rio Preto, São Jose do Rio Preto, Brazil - godoyjmp@gmail.com.|CNPq (National Council for Research and Development), Brasilia, Brazil.
José M
JM
Pereira de Godoy
University of São Paulo, São Paulo, Brazil.
Sergio
S
Quilici Belczak
Department of Vascular and Endovascular Surgery, Hospital Santa Marcelina, São Paulo, Brazil.
Melissa A
MA
de Moraes Silva
Department of Medical Sciences, School of Santa Casa de São Paulo, São Paulo, Brazil.
Roberto A
RA
Caffaro
D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004886:Erysipelas / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008208:Lymphatic System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008209:Lymphedema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D061305:Lymphoscintigraphy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014648:Varicose Veins / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*