title: Our supramicrosurgical experience of lymphaticovenular anastomosis in lymphoedema patients to prevent cellulitis.
abstract: Aim of this paper is to present our reduction of the frequency of cellulitis before and after supramicrosurgical lymphaticovenular anastomosis (s-LVA) in lymphoedema patients, and discuss the possibility to perform this technique outside Japan.
  
  
  
  37 patients affected by lymphoedema were enrolled. All patients received preoperative indocyanine green lymphography. Under local anaesthesia s-LVA was performed on all patients. All patients were followed for 1 year. Lymphoedema was staged using the lymphoedema staging classification recommended by the International Society of Lymphology. Cellulitis rate was recorded for all patients the year before and after the s-LVA. A t-test was used to evaluate differences in the frequency of cellulitis the year before surgery and the year following surgery.
  
  
  
  Cellulitis incidence decreased in all patients, with a mean 1.7 cases the year before s-LVA and 0.1 the year after s-LVA. A significant difference between preoperative and postoperative cellulitis rate was found (p = 0.0012).
  
  
  
  This study reports our s-LVA case series of lymphoedema patients. With the proper learning curve, s-LVA may be reproduced and lymphoedema patients may gain a better quality of life and a reduced cellulitis rate.
authors.affiliation: Department of Maxillofacial Surgery, University of Siena, Siena, Italy. guidogabriele1@yahoo.it.
authors.forename: P
authors.initials: P
authors.lastname: Gennaro
authors.forename: G
authors.initials: G
authors.lastname: Gabriele
authors.forename: C
authors.initials: C
authors.lastname: Salini
authors.forename: G
authors.initials: G
authors.lastname: Chisci
authors.forename: F
authors.initials: F
authors.lastname: Cascino
authors.forename: J-F
authors.initials: JF
authors.lastname: Xu
authors.forename: C
authors.initials: C
authors.lastname: Ungari
mesh_terms: D000714:Anastomosis, Surgical; D002481:Cellulitis / Q000517:prevention & control*; D006801:Humans; D007564:Japan; D042601:Lymphatic Vessels / Q000601:surgery*; D008209:Lymphedema / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies