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Page 10 of 16 Raman et al. Plast Aesthet Res 2023;10:6 https://dx.doi.org/10.20517/2347-9264.2022.62

Table 5. Patient-reported outcomes. A lower score in the functional, appearance, symptom, and mood domains of the LYMQOL reflect a more satisfactory patient response in those categories,
while a higher score in the overall domain in the LYMQOL reflects a more satisfactory patient response.

LYMQOL* VAS* Lymphedema life impact scale V2* Patient scar Questionnaire* Upper limb lymphedema Questionnaire*

F A S M O PN H O P PS F A S P PS SO O
Total -14.7 -6.2 -8.1 -6.7 4.1 -4.0 -5.4 -4.3 -1.8 -1.0 -1.0 1.8 1.5 20 12 19 18

Donor
Groin -13.8 -6.5 -7.8 -5.8 3.5 -4.8 -5.4 -4.3 - - - - - 20 12 19 18
Submental -15.4 -4.6 -8.0 -6.2 4.4 - - - - - - - - - - - -
Omentum -18.1 -10.0 -10.2 -11.6 4.7 -3.2 - - -1.8 -1.0 -1.0 1.8 1.5 - - - -
Supraclavicular† -0.91 -1.0 -1.1 -0.8 2.1 - - - - - - - - - - - -

Lateral thoracic† -0.91 -1.0 -1.1 -0.8 2.1 - - - - - - - - - - - -
Appendicular - - - - - - - - - - - - - - - - -
Ileocecal - - - - - - - - - - - - - - - - -
Jejunal Mesenteric - - - - - - - - - - - - - - - - -
Intra-abdominal Donor site -18.1 -10.0 -10.2 -11.6 4.7 -3.2 - - -1.8 -1.0 -1.0 1.8 1.5 - - - -

Extra-abdominal Donor site -14.1 -5.5 -7.7 -5.8 4.0 -4.8 -5.4 -4.3 - - - - - 20 12 19 18
Recipient site
Upper extremity -15.9 -6.3 -8.6 -6.8 4.1 -4.8 -5.4 -4.3 -1.2 -0.55 -0.50 1.5 1.2 20 12 19 18
Lower extremity -2.9 -2.3 -2.1 -2.4 4.8 -3.2 - - -2.6 -1.5 -1.7 2.3 2.0 - - - -

F: Functional; A: appearance; S: symptom; M: mood; O: overall; PN: pain; H: heaviness; P: physical; PS: psychological; SO: social. †One study reported both donor site outcomes together. *Postoperative-Preoperative
Scores for pain.

Eight articles reported LYMQOL measures for patients who had upper limb lymphedema and 7 articles reported LYMQOL measures for patients with lower
limb lymphedema. Overall, no statistical significance was achieved when comparing upper and lower recipient sites for each LYMQOL domain (P = 0.15).

Imaging outcomes
Thirty of the 66 articles (45.5%) evaluated imaging outcomes. Of these 30 studies, most (22, 73.3%) used lymphoscintigraphy. Seven of these studies looked for
the presence of nodes after VLNT, with two of these studies reporting that the majority of transplanted nodes were functioning postoperatively. Sixteen studies
examined lymphatic drainage patterns, and the majority (14, 87.5%) indicated that flow improved after VLNT. The findings of these investigations are
summarized in Supplementary Table 4.