Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment. After surgery, the patient reported significant improvement in limb volume and the accompanying symptoms. The limb circumference was reduced by an average of 19.2% at 6 months postoperatively. Despite having a short pedicle and small vessel caliber, the lateral intercostal artery perforator flap can safely be used for VLNT in lymphedema patients with anatomical variants.
Arteries* ; Extremities ; Female ; Free Tissue Flaps ; Humans ; Leg ; Lymph Nodes* ; Lymphatic System ; Lymphedema ; Microsurgery ; Perforator Flap ; Tissue Donors* ; Transplantation, Autologous ; Uterine Cervical Neoplasms

OBJECTIVETo evaluate the application value of Optical Coherence Tomography (OCT) in the diagnosis of the depth of burn wound.

METHODSDeep partial-thickness scald models of Skh-1 mice were reproduced using self-made steam scald appliance. The scald wounds were scanned with OCT 3 hours, or 3 and 8 days after injury respectively. Scanned wound tissue was harvested for histological examination right after each episode of OCT imaging. Normal skin of mice was scanned and examined with the above-mentioned methods at the same time.

RESULTSCompared with those of the normal skin, collagen in the dermis was denatured after steam scald, and it was imaged as vanishing or reduction in birefringence in OCT detection. The structure change intensity was related to the pathological process of the wounds and consistent with the corresponding histological results.

CONCLUSIONSOCT is a noninvasive technique. It can be used to diagnose the depth of burn wound in real time.

Animals ; Burns ; diagnostic imaging ; Disease Models, Animal ; Mice ; Radionuclide Imaging ; Tomography, Optical Coherence ; Wound Healing