Objective
Lipodermatosclerosis (LDS), a leathery-looking, flaky, itching skin, is the end-stage presentation, commonly resultant by chronic severe venous insufficiency in the lower extremity. Other caustic factors could be traumatic scars or even any kind of chronic skin inflammation like Psoriasis vulgaris. However, the common finding is usually that of chronic lymphedema, so that sometimes it is combined with lymphorrhea, warty hyperkeratosis, chronic stasis ulcer, and recurrent cellulitis. We propose lymphovenous anastomosis (LVA) could ease the sequential lymphedema to promote wound healing.
Material and Methods
LVA was performed on 20 lower extremities, 15 patients who had recurrent cellulitis several times with lymphorrhea or developed a severe ulcer that was refractory to skin grafts, or conservative therapy.
Results
All patients received 1-3(M= 1.6) incisions of LVAs, and 1-5(M= 2.5) anastomosis shunts that were performed on each extremity. All chronic ulcers either combined with a skin graft or not were healed within 6 weeks. 1 case has recurrent ulceration during the follow-up period (3-22 months, M= 11.1). Besides, lymphorrhea ceased, warty hyperkeratosis vanished, chronic stasis ulcer healed, and no recurrent cellulitis happened during the follow-up period.
Conclusions
LVAs are considered as adjunctive therapy to decrease lymphorrhea and ease the local regional lymphedema in LDS cases. A promising way efficiently shortens wound healing and decreases the health care burden.