Maddox John S, Sabino Jennifer M, Buckingham E Bryan, Mundinger Gerhard S, Zelken Jonathan A, Bluebond-Langner Rachel O, Singh Devinder P, Holton Luther H
Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, Md.; and Division of Plastic Surgery, University of Maryland School of Medicine, Baltimore, Md.
Plast Reconstr Surg Glob Open. 2014 Oct 7;2(9):e210. doi: 10.1097/GOX.0000000000000135. eCollection 2014 Sep.
Surgical manipulation of the groin can result in lymphatic injury in a significant number of patients leading to poor wound healing or infectious complications. Surgical repair of lymphatic injury is greatly aided by the precise and prompt intraoperative localization of the injured lymphatic vessels. We assessed and identified lymphatic leaks in 2 cases of surgical wound lymphorrhea occurring after instrumentation of the groin using laser-assisted indocyanine green lymphography paired with isosulfan blue injection. Both cases healed without complication, and no lymphatic leak recurrence was observed during postoperative follow-up. Laser-assisted indocyanine green lymphography is a useful adjunct in the management of lymphatic leaks after surgery of the groin and may have potential for prophylactic evaluation of high-risk groin wounds.
腹股沟的手术操作会导致大量患者出现淋巴管损伤,进而导致伤口愈合不良或感染并发症。精确且及时地在术中定位受损淋巴管,对手术修复淋巴管损伤有极大帮助。我们使用激光辅助吲哚菁绿淋巴管造影术并联合注射异硫蓝,评估并识别了2例腹股沟器械操作后发生手术伤口淋巴漏的病例中的淋巴漏情况。两例均愈合且无并发症,术后随访期间未观察到淋巴漏复发。激光辅助吲哚菁绿淋巴管造影术是腹股沟手术后淋巴漏管理中的一种有用辅助手段,可能具有对高风险腹股沟伤口进行预防性评估的潜力。