Page 63 - Read Online

Page 6 of 10 Park et al. Plast Aesthet Res 2023;10:40 https://dx.doi.org/10.20517/2347-9264.2022.98

Figure 4. Superficial lymph nodes should be accurately harvested with thin flap elevation in order to minimize iatrogenic lymphedema
risk.

Figure 5. (A) Immediate postoperative photograph of the umbilicus after single-port laparoscopic harvest of the omental flap; (B) 12-
month photograph of the umbilicus.

operation to maintain the positive pressure gradient from the lymphatic duct to the anastomosed vein. In
patients undergoing breast reconstruction with DIEP and LNT, the patient is encouraged to maintain
absolute bed rest for three days. After this period, the patient is allowed for light mobilization to minimize
the potential of anastomosis-related complications. In patients undergoing omental LNT, the patient is
closely monitored for any abdominal discomfort and pain with daily abdomen x-rays. In patients
undergoing SCIP flaps, the routine postoperative free-flap protocol involves minimal ward ambulation,
intravenous Prostaglandin E1 injection, and a low-residue diet for three days.

Di Taranto et al. reported a significant reduction in lower limb circumference and tonicity in both VLNT
and VLNT and LVA groups at 1-year follow-up . However, there was no significant difference between
[15]
the two groups, possibly due to the short follow-up. Garza et al. also reported similar improvements in
volume and quality of life as reported by the Lymphedema Life Impact Scale (LLIS) . Their long-term
[17]
study on both upper and lower extremities analyzed limb volume changes for combined VLNT and LVA
procedures.