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Volume 41 Issue 6
Jun.  2025
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2025  >  41(6): 516-524
Deng Chengliang, Chen Junzhe, Xiao Shun'e, et al. An overview of integrated surgical management for secondary lower limb lymphedema guided by algorithms[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2025, 41(6): 516-524. Doi: 10.3760/cma.j.cn501225-20250217-00067
Citation: Deng Chengliang, Chen Junzhe, Xiao Shun'e, et al. An overview of integrated surgical management for secondary lower limb lymphedema guided by algorithms[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2025, 41(6): 516-524. Doi: 10.3760/cma.j.cn501225-20250217-00067
shu

An overview of integrated surgical management for secondary lower limb lymphedema guided by algorithms

doi: 10.3760/cma.j.cn501225-20250217-00067

  • Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China

Funds:

General Program of National Natural Science Foundation of China 82372541

Regional Science Foundation Project of National Natural Science Foundation of China 82260391

Regional Science Foundation Project of National Natural Science Foundation of China 82360448

Talent Team Construction Project for Basic and Clinical Research on Lymphedema of Guizhou Province 2025-051

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    Abstract
  • Secondary lymphedema is a chronic progressive disease caused by lymphatic flow obstruction due to surgery, trauma, infection, etc., leading to inflammation, edema, adipose deposition, and fibrosis in subcutaneous tissue. While early, standardized, integrated, and sustained treatment is the principle for managing secondary lower limb lymphedema, and the goal is to provide a personalized and standardized treatment. Based on single-center treatment experience, this article summarizes an integrated surgical treatment algorithm for secondary lower limb lymphedema. It proposes that personalized treatment requires comprehensive assessment of lymphedema severity, pathological components, and lymphatic function, incorporating the International Society of Lymphology staging and imaging findings. This algorithm is based on the principles of regionalization (body regions), staged approach, and integrated treatment to achieve precise personalized intervention, which demonstrates certain value for clinical promotion.

     

    • (1) For the first time, specific treatment recommendations were proposed for secondary lower limb lymphedema affecting different regions (thigh and calf), and an innovative integrated treatment algorithm was developed utilizing staged or simultaneous combined therapies based on International Society of Lymphology staging and pathological characteristics of the condition, to thereby enhance therapeutic efficacy and reduce the burden on patients.
    (2) The paper systematically delineated the distinction between "liquid" and "solid" pathological components in secondary lower limb lymphedema, and proposed targeted surgical strategies integrating physiological procedures (such as lymphaticovenous anastomosis and vascularized lymph node transfer) with debulking surgeries (such as liposuction, radical reduction with preservation of perforators, and so on) based on the specific composition of pathological tissue, emphasizing the importance of individualized plan to overcome the limitations of monotherapy.
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