Reconstructive Lymph Vascular Surgery and Other Lymphedema Treatment Modalities

Abstract

Reconstructive lymph vascular surgery is connected to other lymphedema treating modalities.

The surplus of adipose tissue in advanced lymphedemas might not be released solely by improving the lymphatic flow. In these cases a secondary reduction of the surplus of fat with the help of liposuction may supplement the reconstruction in order to achieve a shape of the extremity comparable to the normal size also in advanced stages. Because of the improvement or even complete restoration of the lymphatic outflow due to the previous reconstruction, omitting of compression therapy is possible in a remarkable amount of patients.

Conservative treatment is preceding the reconstructive lymph vascular surgery since patients should get this chance of treatment prior to surgery. Performing half a year of complete decongestive treatment (CDT) is recommended to permit a spontaneous regression.

After the reconstructive procedure, a compression garment is used routinely for about 6 months. This will assist the influx into the anastomoses. Additional CDT is not recommended during this time period since the transport of lymph should be concentrated on the newly formed reconstruction.

After this period only a small part of the patients need additional conservative treatment procedures.