Volume 115, Issue 1 pp. 48-53
Research Article

Platysma-sparing vascularized submental lymph node flap transfer for extremity lymphedema

Igor Poccia MD

Igor Poccia MD

Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

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Chia-Yu Lin MSc

Chia-Yu Lin MSc

Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

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Ming-Huei Cheng MD, MBA

Corresponding Author

Ming-Huei Cheng MD, MBA

Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan

Correspondence to: Ming-Huei Cheng, MD, MBA, FACS, Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 5, Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan. Fax: +886-3-3972681. E-mail: [email protected]; [email protected]

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First published: 06 January 2017
Citations: 27
Commercial Asssociations and Financial Disclosures: No funding was received for this work.
Conflicts of interest: The authors do not have any financial interest or commercial association with subject matter and/or products mentioned in the manuscript.
Level of Evidence: IV (Therapeutic Studies).

Abstract

Background and Objectives

Due to its consistent vascular and lymphatic anatomy, the vascularized submental lymph node flap is a reliable option for lymphedema treatment. Despite these advantages, flap harvest requires resection of platysma, which may cause a marginal mandibular nerve pseudo-paralysis. The aim of this study was to investigate the donor site morbidity of an innovative platysma-sparing vascularized submental lymph node flap transfer for treating extremity lymphedema.

Methods

Ten patients undergoing platysma sparing submental lymph-node flap harvest were prospectively enrolled in the study and compared with a control group of 10 patients who underwent standard submental lymph-node flap harvest. Photogrammetry analysis was used to assess donor site morbidity with regards to marginal mandibular nerve pseudo-paralysis.

Results

All flaps survived. No necrosis of the skin paddle was observed in both groups. There were no marginal mandibular nerve palsies in both group. There were no cases of marginal mandibular nerve pseudo-paralysis in the platysma sparing group.

Conclusions

The platysma sparing submental flap, while offering comparable functional improvement for extremity lymphedema, has the advantages of maximizing nerve and muscular preservation, significantly reducing donor site morbidity. J. Surg. Oncol. 2017;115:48–53. © 2017 Wiley Periodicals, Inc.

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