Abstract:
BACKGROUND: Investigating correlations between clinical, instrumental, and genetic features of primary lymphedema (PL) with the aim to facilitate the diagnosis, the staging, and the management of this subgroup of patients. METHODS: A prospective observational study was conducted from September 2016 to May 2018, including patients with diagnosis of nonsyndromic PL. All patients underwent a lymphoscintigraphic rest-stress test, an indocyanine green (ICG) lymphographic test, and a genetic test from sputum sample. RESULTS: A total of 20 patients were enrolled in the study and 44 limbs were examined. The totality of clinically affected limbs (32/44) showed lymphographic and lymphoscintigraphic abnormalities. Concerning clinically healthy limbs (12/44), an abnormal pattern was demonstrated in 33.3% of ICG lymphographic test and 75% of lymphoscintigraphy. Regarding lymphography findings, the most frequent pattern was the distal dermal backflow (DDB). We distinguished four grades of DDB, which correlates with clinical and lymphoscintigraphic features. Furthermore, we found a new lymphographic alteration consisting of fluorescence appearing distally to the injection site of ICG, including fingers/toes and palmar/plantar surface of the hand and of the foot. This alteration, called "print sign," seems to be typical of DDB pattern PL. Genetic test did not help us make any etiological diagnosis. CONCLUSION: To our knowledge, this is the first study about PL comparing clinical, ICG lymphographic, lymphoscintigraphic, and genetic findings. As expected, all clinically affected limbs showed abnormalities in ICG lymphographic and lymphoscintigraphic tests. In opposition to what has previously been reported, also clinically healthy limbs showed lymphographic and lymphoscintigraphic alterations and this could suggest the existence of a subclinical form of PL. We proposed a grading of the DDB pattern, which correlates with clinical and lymphoscintigraphic features. Furthermore, we have described a new lymphographic alteration that seems to be typical of DDB pattern PL, the "print sign."
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Mangialardi ML,Lorenzano V,Pagliara D,Visconti G,Gentileschi S,Salgarello Mdoi
10.1055/s-0039-1698748subject
Has Abstractpub_date
2020-03-01 00:00:00pages
157-164issue
3eissn
0743-684Xissn
1098-8947journal_volume
36pub_type
杂志文章abstract::Background Although flap transfer is a popular reconstructive procedure with a high success rate, it is associated with a high complication rate and low salvage rate. During the past decade, negative-pressure wound therapy (NPWT) has been increasingly applied to facilitate flap transfer and salvage flaps threatened by...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1599076
更新日期:2017-06-01 00:00:00
abstract::A modified, two-stage arteriovenous flow-through venous flap was designed to repair skin defects due to third-degree burns on the dorsum of the hand in four patients. Two weeks after plasty of an arteriovenous (A-V) shunt between the greater saphenous vein and dorsalis pedis artery, the arterialized flow-through venou...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006429
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:The anterolateral thigh (ALT) flap has been widely used in reconstruction of soft tissue defects. The anatomic variations of perforators increase the difficulties of flap elevation. The ABC system has been described for locating the most common three perforators in Western populations. Less evidence has been...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1343496
更新日期:2013-06-01 00:00:00
abstract::9-0 absorbable polydioxanone (PDS) has been compared to 9-0 nonabsorbable Prolene in order to evaluate any advantages of either suture in microvascular surgery. In each of 29 rats, one carotid artery was anastomosed end-to-end with PDS and the other with Prolene. Specimens were harvested 48 hr, 14 days, and three, and...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006833
更新日期:1990-07-01 00:00:00
abstract::Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-833500
更新日期:2004-08-01 00:00:00
abstract::Facial wounds are frequently associated with bone fractures and multiple trauma; however, disruption of the parotid gland or Stensen's duct is rare and is often associated with facial nerve palsy. Lesions are often undiagnosed on first assessment of the multiple trauma patient. If microsurgical repair of Stensen's duc...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000078
更新日期:1999-02-01 00:00:00
abstract::Closure of massive soft-tissue defects in patients undergoing forequarter amputation for shoulder-girdle tumors may present a daunting challenge. This report describes two patients whose forequarter amputations were closed using ipsilateral, lymphedematous, circumferential forearm fasciocutaneous free flaps. ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006658
更新日期:1993-03-01 00:00:00
abstract::Microsurgical treatment of ring avulsion injuries is often difficult, due to widespread intimal damage of the digital vascular bundles. Thirty-one patients with such injuries in varying degrees were treated during the period 1986 to 1992: of these, 15 underwent microsurgical revascularization. In addition to the tradi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006475
更新日期:1996-04-01 00:00:00
abstract::Although autogenous veins have been used as nerve conduits (AVNCs) both experimentally and clinically for short nerve gaps up to 3 cm, investigators have not as yet determined the maximal effective length for functional nerve regeneration. In addition, the role of the distal nerve stump on subsequent nerve growth rema...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006624
更新日期:1996-11-01 00:00:00
abstract::This study used quantitative PCR in the murine model to compare the ability of a limb allograft vs. a comparable dose of marrow suspension to induce chimerism. Female C57Bl/6 mice received a vascularized hindlimb allograft, a comparable dose of 5 x 10 (6) donor bone marrow cells, or a standard dose (20 x 10 (6)) of ma...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-946716
更新日期:2006-07-01 00:00:00
abstract::The preoperative identification of perforators can facilitate the appropriate design of perforator flaps from the lower extremity. Although computed tomographic arteriography can now be considered the gold standard in this regard, this technology is not universally available or inexpensive, with a nonnegligible risk f...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0029-1220860
更新日期:2009-07-01 00:00:00
abstract::Tissue expansion in combination with flap transfer has been widely reported as preexpansion of flaps, but only once as expansion of a free flap after transfer. Three free flaps and one pedicled flap were expanded after transfer. Indication, timing of expander implantation and explantation, technical aspects, and compl...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-970184
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Clinical diagnosis of sensory disturbances is extremely challenging, partly because the utility of sensory tests is questionable. Transection of C7 nerve root provides an objective assessment model to determine the diagnostic accuracy of sensory tests. The purpose of this study was to investigate the diagnos...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0034-1384819
更新日期:2015-01-01 00:00:00
abstract:: ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,已发布勘误
doi:10.1055/s-0038-1646944
更新日期:2018-06-01 00:00:00
abstract::This paper describes a new technique for microvascular anastomosis, which involves the overlapping of the adventitias of the two ends of a severed blood vessel, and then painting a cyanoacrylate adhesive on the outer surface of the vessel around the anastomosed part. Sixteen anastomoses were performed in both radial a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-824890
更新日期:2004-05-01 00:00:00
abstract::Aberrant reinnervation of target organs caused by misdirected axonal growth at the repair site is a major reason for the poor functional outcome usually seen after peripheral nerve transection and repair. This study investigates whether the criss-crossing of regenerating rat sciatic nerve axons between tibial and pero...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-861524
更新日期:2004-11-01 00:00:00
abstract::Findings reported in the literature on the sensation provided by intraorally applied innervated vs. non-innervated radial forearm free flaps differ. In an effort to understand these differences in sensory recovery, the authors carried out sensory evaluations in 12 patients who had undergone radial forearm free flaps. ...
journal_title:Journal of reconstructive microsurgery
pub_type: 临床试验,杂志文章
doi:10.1055/s-2000-7549
更新日期:2000-04-01 00:00:00
abstract::Vascularized periosteal graft is a frequently applied flap model for bone prefabrication studies due to its inhabitance of osteoprogenitor cells and osteoinductive potential. Various bones such as rib and fibula are reported as a potential source for the harvest of the periosteal flap in experimental studies on higher...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1301068
更新日期:2012-03-01 00:00:00
abstract::A model of chronic entrapment neuropathy in the rabbit sciatic nerve was developed to try to elucidate the pathogenesis of chronic nerve entrapment. A non-compressive Silastic cuff was wrapped around the nerve at the mid-thigh level in eight rabbits. A sham operation that only elevated the sciatic nerve was performed ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000070
更新日期:1999-01-01 00:00:00
abstract::Radical resection of tongue and oropharyngeal carcinomas often results in complex defects that are challenging to reconstruct. Furthermore, remaining function should not be disturbed by the reconstruction. We introduce a new flap design and monitored swallowing and speech following reconstruction of complex oral defec...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1078691
更新日期:2008-04-01 00:00:00
abstract::The lateral forearm flap is being increasingly used for covering minor-to-moderate-sized defects for which soft and thin skin is required. Within the framework of an anatomic study carried out on 28 cadaveric arms, the authors investigated the principal artery that supplies blood to this flap namely, the posterior rad...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-7537
更新日期:2000-01-01 00:00:00
abstract::Greater than 80 percent of free flap thromboses have been shown to occur within the first three postoperative days, warranting immediate re-exploration and restoration of adequate vessel patency. The infrequency of thromboses beyond this period is reflected in the lack of reported cases in the literature and the absen...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-35095
更新日期:2002-10-01 00:00:00
abstract::Nerve decompression surgery for leprosy neuritis has a long history and large literature. New understanding of the high frequency of spontaneous recovery from nerve function impairment requires re-evaluation of the value of decompression in acute nerve dysfunction with strong evidence-based protocols. Several reports ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1248237
更新日期:2010-05-01 00:00:00
abstract::During the last seven years, 17 patients underwent microsurgical reconstruction of 14 hepatic and four superior mesenteric arterial systems following extended pancreatectomy or hepatectomy, and in living-related liver transplantations (LRLT). All microvascular anastomoses in this series were performed using a back wal...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000109
更新日期:1999-07-01 00:00:00
abstract::This study examined the use of freeze-thawed muscle as a nerve graft material in Sprague-Dawley rats. In Group 1 (n = 4), the sciatic nerve was isolated and the incision immediately closed. In Group 2 (n = 4), a 5-mm segment of the nerve was removed and immediately replaced. In Group 3 (n = 50), a 5-mm segment of nerv...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006580
更新日期:1994-05-01 00:00:00
abstract::Multilayered tubes fabricated from human amnion were placed subcutaneously and/or longitudinally in contact with an axial artery and vein in rats. Histologic evaluation at the third postoperative week showed that the tubes had incorporated with the surrounding fibrovascular tissue. New capillary formation within the t...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006749
更新日期:1993-11-01 00:00:00
abstract::The effects of piracetam on flap survival, ischemia-reperfusion (I/R) injury, and vascular endothelial growth factor (VEGF) expression were evaluated in this study. Unipedicled epigastric flap model was used in 36 rats and was evaluated within 4 groups. The flap was elevated and untreated in Group 1. Postoperative pir...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1281523
更新日期:2011-09-01 00:00:00
abstract::The authors conducted a two-part study to determine whether transcutaneous oxygen pressure (TcPO (2)) and transcutaneous carbon dioxide pressure (TcPCO (2)) can be used to monitor flap viability after transplantation. The first part was an animal study in which TcPO (2) and TcPCO (2) were measured in 10 epigastric isl...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-985208
更新日期:2007-07-01 00:00:00
abstract::The tremendous variability of the inferior epigastric arterial system makes accurate imaging of the vasculature of the anterior abdominal wall an essential component of optimal perforator selection. Preoperative imaging of the abdominal vasculature allows for preoperative perforator selection, resulting in improved op...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0029-1220862
更新日期:2010-01-01 00:00:00
abstract::Composite tissue allograft (CTA) transplantation, such as the clinical face and hand transplants, has now been performed in multiple centers across the world. The transplants have successfully treated complex injuries that have either failed conventional approaches or where autologous reconstruction could not restore ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1285988
更新日期:2012-01-01 00:00:00