Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Vacuum-assisted Closure for the Treatment of Lymphorrhea Following Surgery of the Femoral Artery

대퇴동맥 수술 후 발생한 임파루의 음압 요법 치료

  • Chang, Won-Ho (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital) ;
  • Youm, Wook (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital) ;
  • Oh, Hong-Chul (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital) ;
  • Han, Jung-Wook (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital) ;
  • Kim, Hyun-Jo (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital)
  • 장원호 (순천향대학교병원 흉부외과) ;
  • 염욱 (순천향대학교병원 흉부외과) ;
  • 오홍철 (순천향대학교병원 흉부외과) ;
  • 한정욱 (순천향대학교병원 흉부외과) ;
  • 김현조 (순천향대학교병원 흉부외과)
  • Received : 2010.03.03
  • Accepted : 2010.06.14
  • Published : 2010.10.05
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Abstract

Lymphorrhea is a common complication after inguinal dissection for exposure of the femoral artery. Injury of the lymphatics occurs frequently because they are anatomically close to blood vessels. Uncontrolled lymph drainage increases postoperative morbidity, and wound infection may follow. Despite current treatment options, lymphorrhea after inguinal dissection is still difficult to manage and results in a prolonged hospital stay. A vacuum-assisted closure device was used in a 72-year-old woman who had lymphorrhea after vascular surgery by groin incision. Vacuum-assisted control for lymphorrhea resulted in earlier closure of the wound and reduced the length of hospital stay.

임파루는 대퇴부 절개를 이용한 혈관 수술시 흔히 발생하는 합병증이다. 임파선은 해부학적으로 혈관과 매우 가깝게 위치하기 때문에 혈관 노출 과정에서 드물지 않게 손상된다. 임파액을 적절하게 배액시키지 않으면 환자가 다른 합병증으로 이환되는 원인으로 작용할 수 있으며, 흔히 창상 감염을 야기한다. 이에 대한 다양한 치료법이 보고되었음에도 임파루는 치료하기 어렵고 결국에는 재원기간을 연장 시킨다. 서혜부 절개를 이용한 혈관 수술을 받은 72세 여자환자에게서 수술후 임파루가 발생하였으며 창상에 음압 요법을 시행하였다. 조기에 적절한 배액이 되었고, 창상 치유가 원활하여 창상 봉합이 가능하였기에 재원기간을 단축할 수 있었다.

Keywords

References

  1. Schwartz MA, Schanzer H, Skladany M, et al. A comparison of conservative therapy and early selective ligation in the treatment of lymphatic complications following vascular procedures. Am J Surg 1995;170:206-8. https://doi.org/10.1016/S0002-9610(99)80287-6
  2. Skudder PA Jr, Geary J. Lymphatic drainage from the groin following surgery of the femoral artery. J Cardiovasc Surg (Torino) 1987;28:460-3.
  3. Colwell AS, Donaldson MC, Belkin M, et al. Management of early groin vascular bypass graft infections with sartorius and rectus femoris flaps. Ann Plast Surg 2004;52:49-53. https://doi.org/10.1097/01.sap.0000099960.68038.53
  4. Fleischmann W, Strecker W, Bombelli M, et al. Vacuum sealing as a treatment of soft tissue damage is open fractures. Unfallchirurg 1993;96:488-92.
  5. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 1997;38:563-77. https://doi.org/10.1097/00000637-199706000-00002
  6. Venturi ML, Attinger CE, Mesbahi AN, et al. Mechanisms and clinical applications of the Vacuum-Assisted Closure (VAC) Device. Am J Clin Dermatol 2005;6:185-94. https://doi.org/10.2165/00128071-200506030-00005
  7. Dosluoglu HH, Schimpf DK, Schultz R, et al. Preservation of infected and exposed vascular grafts using vacuum assisted closure without muscle flap coverage. J Vasc Surg 2005; 42:989-92. https://doi.org/10.1016/j.jvs.2005.07.006
  8. Babak Abai, Robert WZ, Peter JP, et al. Lymphorrhea responds to negative pressure wound therapy. J Vasc Surg 2007;45:610-3. https://doi.org/10.1016/j.jvs.2006.10.043

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  1. Therapeutic efficacy of vacuum-assisted-closure therapy in the treatment of lymphatic complications following peripheral vascular interventions and surgeries vol.23, pp.1, 2010, https://doi.org/10.1177/1708538114529950