Use of vacuum-assisted closure (VAC) therapy in treating lymphatic complications after vascular procedures: New approach for lymphoceles

Abstract

Lymphatic complications, such as lymphocutaneous fistula (LF) and lymphocele, are relatively uncommon after vascular procedures, but their treatment represents a serious challenge. Vacuum assisted closure (VAC) therapy has been reported to be an effective therapeutic option for LF, but the effectiveness of VAC therapy for lymphoceles is unclear. For LF, we apply the VAC directly to the skin defect after extending it to achieve a clean wound of at least one inch in length. To treat lymphocele, we convert the lymphocele to a LF in a sterile fashion by making a one inch incision in the overlying skin and applying the VAC. The setting was a community teaching hospital. We used 10 patients that we treated with VAC therapy for LF (n = 4) and lymphoceles (n = 6). Duration of in-patient stay, duration of in-patient VAC treatment, duration of out-patient VAC treatment, total duration of VAC treatment. The median duration of in-patient stay was 4 (range, 0-18) days, the median duration of in-patient VAC treatment was 1 (range, 0-5) days, the median duration of out-patient VAC treatment was 16 (range, 7-28) days), and the median total duration of VAC therapy was 18 (range, 13-29) days. Successful wound healing was achieved in all patients with no recurrence after VAC removal. VAC therapy for treatment of both LFs and lymphoceles resulted in early control of drainage, rapid wound closure, and short hospital stays. Our results suggest that VAC therapy is a convenient and effective therapeutic option for both LFs and lymphoceles.