A CASE OF SUCCESSFUL SURGICAL TREATMENT OF A PATIENT WITH LYMPHEDEMA OF LOWER LIMBSJournal: I.P. Pavlov Russian Medical Biological Herald (Vol.26, No. 2)
Publication Date: 2018-06-30
Authors : P.N. Myshencev S.E. Katorkin L.A. Lichman;
Page : 288-295
Keywords : lymphedema; surgical treatment; lower limbs;
The importance of treatment of patients with lymphedema of lower limbs arises from difficulties in their medical and social rehabilitation. At the expressed stages of the disease resection surgical operations are indicated which present complicated interventions. In the work clinical observation of a 33 year-old female patient with IV stage of primary lymphedema of the right lower limb is presented. In the course of conservative treatment after a complex examination including volume try, ultrasound, computed tomography, the patient was made dermalipofascioectomy using method of shave therapy. The operation of modified dermalipofascioectomy of the shin was performed by Karavanov II method under spinal anesthesia with use of mono- and bipolar coagulation. At the stage of elimination of fibrotically changed tissue dermatome Acculan 3Ti (GA 670) was used with controlled ranges of thickness within 0.2-1.2 mm and width within 8-78 mm. Intraoperative loss of blood and lymph was 800 ml and was compensated for with crystalloid, colloid solutions and fresh frozen plasma in the volume of 600 ml. Active drainage of the region of the postoperative wound was conducted by Redon method within 10-12 days. Postoperative period ran without complications, with improvement of the patient's condition. Clinical observation showed a positive role of application of shave therapy apparatus at the main stage of resection operations.
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