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Karnasula VM
Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons.... Date of publication 2012 May 1;volume 45(2):261-5.
1. Indian J Plast Surg. 2012 May;45(2):261-5. doi: 10.4103/0970-0358.101291. Management of ulcers in lymphoedematous limbs. Karnasula VM(1). Author information: (1)Department of Plastic Surgery, G.S.L. Medical College, Rajahmundry, Andhra Pradesh, India. Lymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or worsen. Ulcers in lymphoedema patients, therefore, represent not only a medical but also a psychological problem. The treatment is often regarded as being worse than it actually is. In our study of more than 25 years shows around 10% cases are due to chronic lymphodema. Ulcers of chronic lymphoedema are classified into four stages according to their presentation. Their management depends upon their stage of presentation. Patients with chronic lymphoedema and ulceration require a different approach to treatment. The specific issues associated with managing the patient with lymphoedematous ulceration include, limb shape distortion i.e., elephantiasis, care of the skin creases and folds, and swelling of the toes and fore foot. Stage I ulcers will heal with conservative treatment without any surgical intervention. Stage II ulcers needs debridement of the wound and split-thickness skin grafting. The most difficult to treat are the stage III and IV ulcers, due to associated skin changes and reduced vascularity. These cases need debulking along with excision of the ulcer. In order to prevent recurrence of the ulcer in all the four stages needs prolonged follow-up and limb care. DOI: 10.4103/0970-0358.101291 PMCID: PMC3495376 PMID: 23162225
Appears in following Topics:
Lymphedema - Introduction and Assessment
Lymphedema - Treatment and Emerging Strategies for Prevention
Lymphedema - Introduction and Assessment