Complications and their management in the surgical treatment of Lipohyperplasia dolorosa. English version.

Abstract

There are both conservative and surgical treatment options for Lipohyperplasia dolorosa (LiDo). Aprocedure that has been established since 1997 is the surgical treatment through Lymphological Liposculpture according to Cornely™. After extensive suctioning of the extremities, an extensive subcutaneous wound cavity with atrabecular connective tissue scaffold remains. Nevertheless, surgery-related complications are rare. Postoperative management and administration of antibiotics and antithrombotics are reviewed. The therapies for complications are presented in detail. Retrospectively, the frequencies of adverse events in 1400 LiDo surgeries in 2020 were evaluated. The mean age of the patients was 47.81years (range 16-78years). Symmetrically, 504 outer legs (outer half of the limb [BO]), 504 inner legs (inner half of the limb [BI]), and 392 arms[A] were surgically treated. Relevant adverse events rarely occurred: infections (1.79%), seromas (0.79%), erysipelas (0.28%), necrosis (0.14%) and deep vein thrombosis (0.07). We were able to reduce the rate of postoperative complications to 3.07% in the Lymphological Liposculpture™ regime for the surgical treatment of LiDo. In their meta-analysis on liposuction, Kanapathy etal. reported an overall incidence of major surgical complications of 3.35%. The overall incidence of minor surgical complications was 11.62%, with seroma (5.51%) being the most common minor complication [26]. Kruppa etal. report that the liposuction procedure including fat removal for esthetic reasons has acomplication rate of 9.5%. Wound infections with 4.5% and the formation of erysipelas with 4% are clearly in the foreground [20].