Karlsson Tobias, Hoffner Mattias, Brorson Håkan
Department of Clinical Sciences, Malmö, Lund University, Sweden.
Department of Plastic and Reconstructive Surgery, Skåne University Hospital, Malmö, Sweden.
Plast Reconstr Surg Glob Open. 2022 May 6;10(5):e4314. doi: 10.1097/GOX.0000000000004314. eCollection 2022 May.
Skin infections are a recurring problem for people with lymphedema, and lymphedema has been proven to be the single most important risk factor for developing erysipelas in the leg. This study aimed to determine whether liposuction for late-stage lymphedema reduces the rate of erysipelas in lower extremity lymphedema.
One-hundred twenty-four patients with a median age of 49 years who had liposuction and controlled compression therapy for lower extremity lymphedema were included. Excess volumes were calculated before and after surgery. Median preoperative and postoperative patient years at risk were 11 and 5 years, respectively.
With a total of 1680 preoperative person years at risk and 335 bouts of erysipelas experienced in 64 patients, the preoperative incidence rate was 0.20 bouts per person per year, and the period prevalence was 52%. Postoperatively, the patients were followed over a total of 763 person years at risk, and 28 patients experienced a total of 53 bouts of erysipelas, resulting in a postoperative incidence rate of 0.07 bouts per person per year, and a period prevalence of 23%. This represents a 65% decrease in the erysipelas incidence rate ( < 0.001). The preoperative median excess volume of 3158 ml was reduced with a median of 100% ( < 0.0001).
Liposuction and controlled compression therapy significantly reduce the risk for erysipelas in lower extremity lymphedema and completely reduces the excess volume. This finding is similar to our previous research including patients with upper extremity lymphedema.
皮肤感染是淋巴水肿患者反复出现的问题，并且淋巴水肿已被证明是腿部发生丹毒的最重要单一风险因素。本研究旨在确定晚期淋巴水肿的抽脂术是否能降低下肢淋巴水肿患者丹毒的发生率。
纳入124例年龄中位数为49岁的接受了抽脂术及下肢淋巴水肿控制性压迫治疗的患者。计算手术前后的多余组织量。术前和术后患者的中位风险人年数分别为11年和5年。
术前共有1680人年的风险期，64例患者发生了335次丹毒发作，术前发病率为每人每年0.20次发作，期间患病率为52%。术后，患者共随访了763人年的风险期，28例患者共经历了53次丹毒发作，术后发病率为每人每年0.07次发作，期间患病率为23%。这表明丹毒发病率下降了65%（<0.001）。术前多余组织量中位数为3158毫升，术后中位数减少了100%（<0.0001）。
抽脂术和控制性压迫治疗可显著降低下肢淋巴水肿患者发生丹毒的风险，并完全减少多余组织量。这一发现与我们之前纳入上肢淋巴水肿患者的研究结果相似。
