Abstract
secondary forms of lymphedema may occur as consequence of tumors, surgeries, radiotherapy, trauma and infections. Degloving injuries are severe and infrequent forms of trauma, with avulsion at the level of muscular fascia, and consequent injury of the lymphatic system. to evaluate the alterations in lymphatic circulation in patients being victims of circumferential degloving injuries in the lower limbs, using lymphoscintigraphic. retrospective analysis of the cases treated in the period from 2010 to 2016. Segmental, circumferential and unilateral injuries with involvement of the lower limbs were included. Lymphoscintigraphy was performed after a minimum interval of 12 months after the end of treatment. The non-injured lower limb was used as control. The Kleinhans Semiquantitative Index (KSI) was used for the semiquantitative evaluation of the lymphoscintigraphic findings. eighteen patients were evaluated, six of whom were female and 12 were male. The mean age was 28.11 years. The average vertical extension of the circumferential traumatized segment was 29.33cm. The injured area presented variations of 5 to 15% of the body surface, with an average of 8.95%. Lymphoscintigraphy was performed after an average interval of 22.55 months. Alterations were observed on the traumatized limb (TL) in 13 patients. All control limbs (CL) were normal. The mean KSI observed in TL was 8.32, while in CL, the average value was 0.58 (p<0.001). patients with circumferential degloving injuries in the lower limbs present compromised lymphatic circulation and high probability to develop lymphedema.
Highlights
The of lymphatic capillaries system is a complex network, made up and lymphatic vessels, lymph nodes, and lymphatic organs, which are vitally important for the maintenance of liquid homeostasis and for immunological aspects[1].Lymphedema can be understood as a manifestation of the insufficiency of the lymphatic system due to an alteration in circulation, that is, a reduction in transport of primary or secondary origin
Alterations were observed on the traumatized limb (TL) in 13 patients
This study aims to evaluate the sequelae and alterations of the lymphatic drainage in victims of circumferential degloving injuries of the lower limbs, based on lymphoscintigraphic analysis
Summary
The of lymphatic capillaries system is a complex network, made up and lymphatic vessels, lymph nodes, and lymphatic organs, which are vitally important for the maintenance of liquid homeostasis and for immunological aspects[1]. Lymphedema can be understood as a manifestation of the insufficiency of the lymphatic system due to an alteration in circulation, that is, a reduction in transport of primary or secondary origin. It should not be understood only as a simple local edema process, but as a complex and systemic disease[2,3]. There are clinical signs, which are usually more accentuated the greater the degree of stasis and the longer the duration of the process.
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