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Vascular Procedure
Lymphoedema

Swelling of the limbs due to collection of lymphatic fluid can be managed medically or surgically.

Management

The aims of treatment are to:
Reduce limb swelling Improve limb function Reduce the risk of infection
Conservative treatment

General skin care will reduce risk of infection Swelling can be reduced by elevation Physiotherapy and manual lymph drainage may help External pneumatic compression will also reduce swelling Once swelling is reduced compression stockings should be applied Antibiotics should be given at the first sign of infection Drugs (e.g. diuretics) are of no proven benefit
Surgery

Surgery consists of two approaches Debulking operations Bypass procedures Debulking operations include: Homan's operation - elliptical excisions of skin and subcutaneous tissue with primary closure Charles' operation - radical excision of skin and subcutaneous tissue with skin grafts Both produce good functional results Cosmesis is often poor Bypass operations include: Skin and muscle flaps Omental bridges Enteromesenteric bridges Enteromesenteric bridges Lymphaticovenous anastomosis