Department of Dermatology and Allergology, Dresden, Germany.
Centre of Physical Therapy and Rehabilitative Medicine, Dresden, Germany.
Clin Cosmet Investig Dermatol. 2014 Jan 23;7:35-42. doi: 10.2147/CCID.S56655. eCollection 2014.
Lipedema is a rare female disorder with a characteristic distribution of adipose tissue hypertrophy on the extremities, with pain and bruising. In advanced stages, reduction of adipose tissue is the only available effective treatment. In elderly patients with advanced lipedema, correction of increased skin laxity has to be considered for an optimal outcome.
We report on a tailored combined approach to improve advanced lipedema in elderly females with multiple comorbidities. Microcannular laser-assisted liposuction of the upper legs and knees is performed under tumescent anesthesia. Medial thigh lift and partial lower abdominoplasty with minimal undermining are used to correct skin laxity and prevent intertrigo. Postsurgical care with nonelastic flat knitted compression garments and manual lymph drainage are used.
We report on three women aged 55-77 years with advanced lipedema of the legs and multiple comorbidities. Using this step-by-step approach, a short operation time and early mobilization were possible. Minor adverse effects were temporary methemoglobinemia after tumescent anesthesia and postsurgical pain. No severe adverse effects were seen. Patient satisfaction was high.
A tailored approach may be useful in advanced lipedema and is applicable even in elderly patients with multiple comorbidities.
脂肪营养不良是一种罕见的女性疾病，其特征是四肢脂肪组织肥大，并伴有疼痛和瘀伤。在晚期，减少脂肪组织是唯一有效的治疗方法。对于患有晚期脂肪营养不良的老年患者，为了获得最佳效果，必须考虑纠正增加的皮肤松弛度。
我们报告了一种针对患有多种合并症的老年女性的改良联合方法，以改善晚期脂肪营养不良。在肿胀麻醉下进行小腿和膝盖的微创管状激光辅助吸脂术。内侧大腿提升术和部分下腹成形术（最小程度的皮下剥离）用于纠正皮肤松弛度并预防间擦疹。术后使用非弹性平纹针织压缩服装和手动淋巴引流进行护理。
我们报告了 3 名年龄在 55-77 岁之间的女性，她们患有腿部晚期脂肪营养不良和多种合并症。使用这种逐步方法，可以实现较短的手术时间和早期活动。轻微的不良反应是肿胀麻醉后的短暂高铁血红蛋白血症和术后疼痛。没有严重的不良反应。患者满意度高。
改良方法可能对晚期脂肪营养不良有用，即使对于患有多种合并症的老年患者也适用。
