Surgical management of thirty-nine children with lymphedema.

Thirty-nine children underwent staged excisional surgery for lymphedema. The procedures are described in detail. All the children operated on have improved and have a more normal appearance. The decrease in attacks of cellulitis and lymphangitis is striking. The morbidity of this simple procedure is negligible. The operation is tedious, fatiguing, anatomically unexciting, and has a vague end-point. At this time, staged subcutaneous excision appears to be the procedure of choice in moderate to severe lymphedema in children regardless of etiology or classification. The procedure is not a cure.