Abstract book - ESPRAS

25.8% of them had various types of wound healing problems like infection,
detachment, partial or total necrosis. Majority of these patients had diabetes
or high tension electric burn injury.
Conclusion
Vascular anatomy and etiopathology behind the defect should be very well
known in the reconstructive approach to the lower extremity wounds in order
to make a better decision and planning before the closure. Besides, expertise
on local flap use and skills in microsurgical technique will definitely lower
the complication and amputation rates in difficult cases of lower extremity.
H7. Lymphatic reconstruction as a new concept in lymphoedema
surgical treatment
Stritar A., Leskovsek A., Solinc M., Beslic N.
Department for Plastic, Reconstructive Surgery and Burns, Clinical Center,
Ljubljana, Slovenia
In the last decade some new surgical methods for restoration of lymph flow
are described. Some are in experimental research and few are clinically used.
They represent a vascular implantation of a healthy, new lymphatic tissue
into lymphoedematous limb, what it means an inner incorporated flap, as a
conduit for lymph drainage. Reconstruction itself is more complex and
demanding, as bridging or shunting operations, where free omentum, free
lymph perinodal - node and vascularised lymphatico adipovenous flaps are
used.
All the methods must be individually selected to lymphoscintigraphic
findings, local tissue conditions, axioms of lymphoedema surgery and
general condition and aim of a patient. In general, the results of lymphatic
reconstruction operations are still badly evaluated and our experiences and
conclusions are positioned. Theoretical considerations are sometimes
discordant to practical surgical skills and abilities.
We operated 6 patients, as a microsurgical transfer of a lymph node and 2
patients as a bridged omentum major flap, while some patients are recruited
for lymphaticoadipovenous transfer, for secondary lymphoedema.
Results of a lymph node transfer are not finally completed. Our experiences
point out, that surgical release of a scar was in benefit, and healthy lymph
nodes must be selected. According to this fact in a case of lymphatic
systemic predisposition a donor area must be examined by a
lymphoscintigraphic or ultrasound findings.
All mentioned operations above also need more ethical and forensic consent.