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No-fat diet for treatment of donor site chyle leakage in vascularized supraclavicular lymph node transfer

Archives of Craniofacial Surgery 2020년 21권 6호 p.376 ~ 379
성익현, 박진우, 우경제,
소속 상세정보
성익현 ( Seong Ik-Hyun ) - Ewha Womans University School of Medicine Ewha Womans University Mokdong Hospital Department of Plastic and Reconstructive Surgery
박진우 ( Park Jin-Woo ) - Ewha Womans University School of Medicine Ewha Womans University Mokdong Hospital Department of Plastic and Reconstructive Surgery
우경제 ( Woo Kyong-Je ) - Ewha Womans University School of Medicine Ewha Womans University Mokdong Hospital Department of Plastic and Reconstructive Surgery

Abstract


Supraclavicular lymph node (SCLN) flap is a common donor site for vascularized lymph node transfer for the treatment of lymphedema. Chyle leakage is a rare but serious complication after harvesting SCLN flap in the neck. We report a case of chyle leakage at the SCLN donor site and its successful management. A 52-year-old woman underwent SCLN transfer for treatment of lower extremity lymphedema. After starting a regular diet and wheelchair ambulation on the 3rd postoperative day, the amount of drainage at the donor site increased (8?62 mL/day) with the color becoming milky, which suggested a chyle leak. Despite starting a low-fat diet on the 4th postoperative day, the chyle leakage persisted (70 mL/day). The patient was started on fat-free diet on the 5th postoperative day. The amount of drainage started to decrease and the drain color became more clear within 24 hours. The drainage amount remained less than 10 mL/day from the 8th postoperative day, and we removed the drain on the 12th postoperative day. There was no seroma or other wound complications at follow-up 4 weeks after the operation. The current case demonstrates that a fat-free diet can be a first-line treatment for low output chyle leakage after a SCLN flap.

키워드

Chyle; Free tissue flaps; Lymph nodes; Lymphedema

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