Surgical Treatment of Extensive Lymphatic Malformation in Extremity.
- Author:
Jeong Tae KIM
1
;
Chang Yeon KIM
;
Woo Jin SHIN
;
Dong In JO
Author Information
1. Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea. jtkim@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Lymphatic malformation
- MeSH:
Angiography;
Cellulitis;
Extremities*;
Fever;
Free Tissue Flaps;
Head;
Hemorrhage;
Hot Temperature;
Humans;
Magnetic Resonance Imaging;
Male;
Neck;
Recurrence;
Sepsis;
Skin;
Tourniquets
- From:Journal of the Korean Society of Plastic and Reconstructive Surgeons
2003;30(5):566-572
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Lymphatic malformation in the extremity is usually extensive with its indiscrete margin, and is often associated with vesicle-like skin lesions and bleeding caused by trauma. In case of extensive lesion, even subtle upper respiratory infection can easily lead to local heat and progress to cellulitis and sepsis. So lymphatic malformations, although benign and not known to have malignant degeneration, can be debilitating to the patient. Fortunately, lymphatic malformation in extremity is accessible to radical resection and recurrence can be reduced significantly compared to the lesion in trunk or head and neck. We have experienced five patients(2 males and 3 females) with extensive lymphatic malformation in extremity. Patients were evaluated with radiologic modalities (MRI, MR angiography, color Doppler image) preoperatively, underwent radical resection and reconstructive surgery using tourniquet to minimize the bleeding. The extensive skin and soft tissue defects after resection were covered with free flap(3 cases), split-thickness skin graft(2 cases), and primary closure(2 cases). During Follow-up(mean 29 months), there was no recurrence and frequent symptoms of infection, fever, and skin lesion were also disappeared. In treating lymphatic malformations in extremities, the precise preoperative evaluation using radiologic modalities including MRI and color Doppler image are important, because they are very helpful to define its boundaries and vascularity. Although there are many modalities of treatment of lymphatic malformations, surgical excision is treatment of choice and complete excision is possible especially in extremity, if tourniquet was applied. In order to prevent the recurrence, the coverage with healthy normal tissue including free flap in large defect is requisite after radical resection.
