title: Vascularized Free Lymph Node Flap Transfer in Advanced Lymphedema Patient after Axillary Lymph Node Dissection.
abstract: Lymphedema is a condition characterized by tissue swelling caused by localized fluid retention. Advanced lymphedema is characterized by irreversible skin fibrosis (stage IIIb) and nonpitting edema, with leather-like skin, skin crypts, and ulcers with or without involvement of the toes (stage IVa and IVb, respectively). Recently, surgical treatment of advanced lymphedema has been a challenging reconstructive modality. Microvascular techniques such as lymphaticovenous anastomosis and vascularized lymph node flap transfer are effective for early stage lymphedema. In this study, we performed a two-stage operation in an advanced lymphedema patient. First, a debulking procedure was performed using liposuction. A vascularized free lymph node flap transfer was then conducted 10 weeks after the first operation. In this case, good results were obtained, with reduced circumferences in various parts of the upper extremity noted immediately postoperation.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Cook
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Myong Chul
authors.initials: MC
authors.lastname: Park
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Il Jae
authors.initials: IJ
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Jung
keywords: Breast neoplasms; Lipectomy; Lymphedema; Mastectomy; Vascularized composite allotransplantation