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physioscience 2013; 9(3): 91-96
DOI: 10.1055/s-0033-1335469
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Effektivität von Manueller Lymphdrainage zur Behandlung eines Seroms nach Latissimus-dorsi-flap-Brustrekonstruktion

Literaturübersicht und FallbeschreibungEffectiveness of Manual Lymphatic Drainage in Seroma Treatment after Latissimus Dorsi Flap Breast ReconstructionLiterature Review and Case Study
M. Eidenberger
Further Information

Publication History

06 November 2012

11 March 2013

Publication Date:
04 September 2013 (online)

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Zusammenfassung

Hintergrund: Der M.-latissimus-dorsi-Flap ist eine nach Brustoperationen oft gewählte Variante zum Wiederaufbau der weiblichen Brust. Postoperativ stellt das dorsale Serom mit ca. 20 % Inzidenz eine der häufigsten Komplikationen dar. Die Behandlung umfasst üblicherweise Punktion und Absaugung.

Ziel: Als alternative Behandlungsmöglichkeit zur Resorption des Seroms wird die Manuelle Lymphdrainage vorgestellt.

Methode: Die bereits 2-mal wegen eines dorsalen Seroms punktierte 47-jährige Patientin wurde nach Wiederansammlung eines Flüssigkeitsdepots mit Manueller Lymphdrainage behandelt.

Ergebnis: Das Serom war schon nach der 1. Behandlung deutlich reduziert und nach der 2. Behandlung nachhaltig verschwunden.

Schlussfolgerung: In dieser Fallstudie stellte die Manuelle Lymphdrainage eine erfolgreiche Behandlung des Seroms nach M.-latissimus-dorsi-Flap dar.

Abstract

Background: M. latissimus dorsi flap is a frequently used reconstruction method after female breast surgery. Dorsal seroma formation as one of the most common postoperative complications has an incidence of about 20 %. Treatment consist of puncture and suction.

Objective: Manual lymphatic drainage is portrayed as alternative therapeutic option to seroma resorption.

Method: The 47-year old woman, already having been punctured twice due to seroma was treated with manual lymphatic drainage after liquid reaccumulation.

Result: After the very first treatment the seroma was distinctively reduced and after the second treatment it lastingly disappeared.

Conclusion: In this case study manual lymphatic drainage was considered to be a successful treatment modality for seroma after latissimus dorsi flap.

Schlüsselwörter

Serom - M.-latissimus-dorsi-Flap - Manuelle Lymphdrainage

Key words

seroma - latissimus dorsi flap - manual lymphatic drainage
 

  • Literatur

  • 1 Andrades P, Prado A. Composition of postabdominoplasty seroma. Aesthetic Plast Surg 2007; 31: 514-518
    CrossrefPubMedGoogle Scholar
  • 2 Arrault M, Vignes S. Risk factors for developing upper limb lymphedema after breast cancer treatment. Bull Cancer 2006; 93: 1001-1006
    PubMedGoogle Scholar
  • 3 Bonomi S, Settembrini F, Salval A et al. Current indications for and comparative analysis of three different types of latissimus dorsi flaps. Aesthetic Surgery Journal/The American Society for Aesthetic Plastic Surgery 2012; 32: 294-302
    PubMedGoogle Scholar
  • 4 Breier G. Lymphangiogenesis in regenerating tissue: is VEGF-C sufficient?. Circ Res 2005; 96: 1132-1134
    CrossrefPubMedGoogle Scholar
  • 5 Bringezu G, Schreiner O. Lehrbuch der Entstauungstherapie. Bd. 1: Grundlagen, Beschreibung und Bewertung der Verfahren. Heidelberg: Springer; 2006
    Google Scholar
  • 6 Burgic M, Bruant RodierC, Wilk A et al. Complications following autologous latissimus flap breast reconstruction. Bosnian Journal of Basic Medical Sciences Association of Basic Medical Sciences 2010; 10: 65-67
    PubMedGoogle Scholar
  • 7 Button J, Scott J, Taghizadeh R et al. Shoulder function following autologous latissimus dorsi breast reconstruction. A prospective three-year observational study comparing quilting and non-quilting donor site techniques. J Plast Reconstr Aesthet Surg 2010; 63: 1505-1512
    CrossrefPubMedGoogle Scholar
  • 8 Chang DW, Youssef A, Cha S et al. Autologous breast reconstruction with the extended latissimus dorsi flap. Plastic and Reconstructive Surgery 2002; 110: 751-759
    CrossrefPubMedGoogle Scholar
  • 9 Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM 2005; 98: 343-348
    CrossrefPubMedGoogle Scholar
  • 10 Delay E, Gounot N, Bouillot A et al. Autologous latissimus breast reconstruction: a 3-year clinical experience with 100 patients. Plastic Reconstr Surg 1998; 102: 1461-1478
    CrossrefPubMedGoogle Scholar
  • 11 Devoogdt N, Van Kampen M, Geraerts I et al. Different physical treatment modalities for lymphoedema developing after axillary lymph node dissection for breast cancer: a review. Eur J Obstet Gynecol Reprod Biol 2010; 149: 3-9
    CrossrefPubMedGoogle Scholar
  • 12 Djohan R, Gage E, Gatherwright J et al. Patient satisfaction following nipple-sparing mastectomy and immediate breast reconstruction: an 8-year outcome study. Plast Reconstr Surg 2010; 125: 818-829
    PubMedGoogle Scholar
  • 13 Downey HF, Durgam P, Williams AG et al. Lymph flow in the thoracic duct of conscious dogs lymphatic pump treatment, exercise, and expansion of extracellular fluid volume. Lymphatic Research and Biology 2008; 6: 3-13
    CrossrefPubMedGoogle Scholar
  • 14 Földi M, Földi E. Das Lymphödem. Stuttgart: Fischer; 1993
    Google Scholar
  • 15 Földi M, Kubik S. Lehrbuch der Lymphologie für Mediziner und Physiotherapeuten. Stuttgart: Fischer; 1993
    Google Scholar
  • 16 Földi M, Földi E, Kubik S. Lehrbuch der Lymphologie. München: Elsevier; 2005
    Google Scholar
  • 17 Fu MR, Guth AA, Cleland CM et al. The effects of symptomatic seroma on lymphedema symptoms following breast cancer treatment. Lymphology 2011; 44: 134-143
    PubMedGoogle Scholar
  • 18 Gisquet H, Delay E, Paradol PO et al. Prevention of seroma by quilting suture after harvesting latissimus dorsi flap. The „Chippendale“ technic. Ann Chir Plast Esthet 2010; 55: 97-103
    CrossrefPubMedGoogle Scholar
  • 19 Hayes K, Walton JR, Szomor ZR et al. Reliability of five methods for assessing shoulder range of motion. The Australian Journal of Physiotherapy 2001; 47: 289-294
    PubMedGoogle Scholar
  • 20 Herpertz U. Ödeme und Lymphdrainage. Diagnose und Therapie von Ödemkrankheiten. Stuttgart: Schattauer; 2003
    Google Scholar
  • 21 Hoffmann J, Almstedt-Haug P. Brustrekonstruktion mit Latissimus-dorsi-Flap – Funktionswechsel. physiopraxis 2012; 10: 36-39
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Huang TW, Tseng SH, Lin CC et al. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol 2013; 11: 15
    CrossrefPubMedGoogle Scholar
  • 23 Hutzschenreuter P, Brümmer H. Lymphangiomotoricity and tissue pressure. Zeitschrift für Lymphologie 1986; 10: 55-57
    PubMedGoogle Scholar
  • 24 Spirgi-Gantert I, Suppé B (Hrsg). FBL Klein-Vogelbach Functional Kinetics: Die Grundlagen: Bewegungsanalyse, Untersuchung, Behandlung. Heidelberg: Springer; 2004
    Google Scholar
  • 25 Kumar S, Lal B, Misra MC. Post-mastectomy seroma: a new look into the aetiology of an old problem. J R Coll Surg Edinb 1995; 40: 292-294
    PubMedGoogle Scholar
  • 26 Lohela M, Saaristo A, Veikkola T et al. Lymphangiogenic growth factors, receptors and therapies. Thromb Haemost 2003; 90: 167-184
    PubMedGoogle Scholar
  • 27 Loo WT, Chow LW. Factors predicting seroma formation after mastectomy for Chinese breast cancer patients. Indian Journal of Cancer 2007; 44: 99-103
    CrossrefPubMedGoogle Scholar
  • 28 McCaul JA, Aslaam A, Spooner RJ et al. Aetiology of seroma formation in patients undergoing surgery for breast cancer. Breast (Edinburgh) 2000; 9: 144-148
    CrossrefPubMedGoogle Scholar
  • 29 Menke H, Erkens M, Olbrisch RR. Evolving concepts in breast reconstruction with latissimus dorsi flaps: results and follow-up of 121 consecutive patients. Annals of Plastic Surgery 2001; 47: 107-114
    CrossrefPubMedGoogle Scholar
  • 30 Munhoz AM, Montag E, Fels KW et al. Outcome analysis of breast-conservation surgery and immediate latissimus dorsi flap reconstruction in patients with T1 to T2 breast cancer. Plastic and Reconstructive Surgery 2005; 116: 741-752
    CrossrefPubMedGoogle Scholar
  • 31 Munhoz AM, Aldrighi C, Montag E et al. Periareolar skin-sparing mastectomy and latissimus dorsi flap with biodimensional expander implant reconstruction: surgical planning, outcome, and complications. Plastic and Reconstructive Surgery 2007; 119: 1637-1649 discussion 1650–1652
    CrossrefPubMedGoogle Scholar
  • 32 Naguib SF. Expanding the role of breast conservation surgery by immediate volume replacement with the latissimus dorsi flap. Journal of the Egyptian National Cancer Institute 2006; 18: 216-226
    PubMedGoogle Scholar
  • 33 Pinsolle V, Grinfeder C, Mathoulin-Pelissier S et al. Complications analysis of 266 immediate breast reconstructions. Journal of Plastic, Reconstructive & Aesthetic Surgery  2006; 59: 1017-1024
    PubMedGoogle Scholar
  • 34 Schad H. Innervation der Lymphgefäße und neuronale Regulation des Lymphtransports. Lymphologie in Forschung und Praxis 2007; 11: 14-24
    PubMedGoogle Scholar
  • 35 Shamley DR, Barker K, Simonite V et al. Delayed versus immediate exercises following surgery for breast cancer: a systematic review. Breast Cancer Research and Treatment 2005; 90: 263-271
    CrossrefPubMedGoogle Scholar
  • 36 Taghizadeh R, Shoaib T, Hart AM et al. Triamcinolone reduces seroma re-accumulation in the extended latissimus dorsi donor site. Journal of Plastic, Reconstructive & Aesthetic Surgery 2008; 61: 636-642
    CrossrefPubMedGoogle Scholar
  • 37 Tan IC, Maus EA, Rasmussen JC et al. Assessment of lymphatic contractile function after manual lymphatic drainage using near-infrared fluorescence imaging. Arch Phys Med Rehabil 2011; 92: 756-764
    CrossrefPubMedGoogle Scholar
  • 38 Veber M, Guerin AN, Faure C et al. Breast reconstruction using muscle sparing latissimus dorsi flap and fat grafting. Annales de Chirurgie Plastique et Esthétique 2012; 57: 366-372
    CrossrefPubMedGoogle Scholar
  • 39 Venus MR, Prinsloo DJ. Immediate breast reconstruction with latissimus dorsi flap and implant: audit of outcomes and patient satisfaction survey. Journal of Plastic, Reconstructive & Aesthetic Surgery 2010; 63: 101-105
    CrossrefPubMedGoogle Scholar
  • 40 Watt-Boolsen S, Nielsen VB, Jensen J et al. Postmastectomy seroma. A study of the nature and origin of seroma after mastectomy. Danish Medical Bulleti 1989; 36: 487-489
    PubMedGoogle Scholar
  • 41 Weissleder H, Schuchhardt C. (Hrsg). Erkrankungen des Lymphgefäßsystems. Essen: Viavital; 2006
    Google Scholar
  • 42 Wu J, Di GH, Chen TW et al. A retrospective study of 129 cases with immediate breast reconstruction after skin-sparing mastectomy for breast cancer. Chinese Journal of Surgery 2008; 46: 737-740
    PubMedGoogle Scholar