title: Platysma-sparing vascularized submental lymph node flap transfer for extremity lymphedema.
abstract: OBJECTIVE
  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. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Igor
authors.initials: I
authors.lastname: Poccia
authors.affiliation: Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Cheng
mesh_terms: D005121:Extremities / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000098:blood supply* / Q000637:transplantation*; D008209:Lymphedema / Q000601:surgery*; D008875:Middle Aged; D000069259:Superficial Musculoaponeurotic System / Q000098:blood supply / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000601:surgery*; D020858:Tissue and Organ Harvesting / Q000379:methods
keywords: donor site morbidity; platysma sparing submental lymph-node flap; vascularized lymph-node transfer