Foot lymphoedema—is there a role for surgery?

Foot lymphoedema—is there a role for surgery? Lymphoedema involving the foot is an extremely debilitating condition. Literature review demonstrates that, despite a number of previously attempted procedures, such as debulking and bypass operations, the role of surgery in the management of lymphoedema remains empirical. Moreover, surgery involving the foot has well and truly been assigned to the history books due to high complication rates often leading to amputation. We describe a case of symptomatic foot lymphoedema that was successfully treated with radical debulking, skin grafting and compression garments. Our aim is to highlight the lack of literature on the surgical management of foot lymphoedema and, more importantly, to stimulate discussion on the role of debulking surgery in the management of symptomatic refractory foot lymphoedema. We conclude that, although amputation always remains a potential risk, in selected cases, debulking of a lymphoedematous foot should be attempted before amputation, as it significantly improves quality of life. We highly recommend debulking and reconstruction as a limb-saving approach with a significant improvement in quality of life. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Foot lymphoedema—is there a role for surgery?

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Publisher
Springer-Verlag
Copyright
Copyright © 2013 by Springer-Verlag Berlin Heidelberg
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-011-0676-9
Publisher site
See Article on Publisher Site

Abstract

Lymphoedema involving the foot is an extremely debilitating condition. Literature review demonstrates that, despite a number of previously attempted procedures, such as debulking and bypass operations, the role of surgery in the management of lymphoedema remains empirical. Moreover, surgery involving the foot has well and truly been assigned to the history books due to high complication rates often leading to amputation. We describe a case of symptomatic foot lymphoedema that was successfully treated with radical debulking, skin grafting and compression garments. Our aim is to highlight the lack of literature on the surgical management of foot lymphoedema and, more importantly, to stimulate discussion on the role of debulking surgery in the management of symptomatic refractory foot lymphoedema. We conclude that, although amputation always remains a potential risk, in selected cases, debulking of a lymphoedematous foot should be attempted before amputation, as it significantly improves quality of life. We highly recommend debulking and reconstruction as a limb-saving approach with a significant improvement in quality of life.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Jan 1, 2013

References

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