Sol Alt Ekstremite Tümör Rezeksiyon Protezi Olan Genç Kadın Hastada Metalloz Nedeniyle Yapılan Cerrahi Debridman Sonrası Gelişen Lenfödem: Olgu Sunumu

Öz

Lenfödem, lenfatik drenajın bozulmasından dolayı lenfatik sıvının interstisyel kompartmanda birikmesi ile karakterize olan lokalize bir ödem formudur. Sekonder lenfödem nedenlerinden birisi de ortopedik cerrahi girişimlerdir. Ortopedik cerrahi sonrası lenfödem gelişen hastalarda hastalığın ilerlemesini önlemek için lenfödemin erken tanınması ve tedaviye başlanılması önem arz etmektedir. Bu hastalarda görülen semptomların postoperatif ödem ve vasküler komplikasyonlarla örtüşebilecek olması nedeniyle tanısal sürecin ayrıntılandırılması gerebilmektedir. Bu çalışmada ortopedik cerrahi girişimler ile ilişkili sekonder lenfödem gelişimi olabileceğine dikkat çekmek amacıyla metalloz nedeniyle yapılan cerrahi debridman sonrasında lenfödem gelişen 26 yaşında kadın bir vaka sunulmaktadır.

Anahtar Kelimeler

• Lenfödem
• Cerrahi
• Debridman
• Sekonder
• Protez
• Metalloz
• Komplet Dekonjestif Terapi

Lymphedema After Surgical Debridement for Metallosis in a Young Female Patient with Left Lower Extremity Tumor Resection Prosthesis: Case Report

Öz

Lymphedema is a localized form of edema characterized by accumulation of lymphatic fluid in the interstitial compartment due to impaired lymphatic drainage. One of the causes of secondary lymphedema is orthopedic surgery. In patients who develop lymphedema after orthopedic surgery, early recognition of lymphedema and initiation of treatment is important to prevent the progression of the disease. Since the symptoms seen in these patients may overlap with postoperative edema and vascular complications, it may be necessary to elaborate the diagnostic process. In this study, we report a 26-year-old woman who developed lymphedema after surgical debridement for metallosis to draw attention to the possibility of secondary lymphedema associated with orthopedic surgical interventions.

Anahtar Kelimeler

• Lymphedema
• Surgery
• Debridement
• Secondary
• Prothesis
• Metallosis
• Complete Deconjestive Therapy

Kaynakça

1. 1. Grada, A.A, Phillips, T.J. Lymphedema: Pathophysiology and clinical manifestations. Journal of the American Academy of Dermatology, 2017, 77(6), 1009–1020.
2. 2. Greene A.K. Epidemiology and morbidity of lymphedema. In: Greene, A.K, Slavin, S.A, Brorson, H (Ed) Lymphedema Presentation, Diagnosis, and Treatment, , Springer, Cham 2015. p.33.
3. 3. Minasian R.A, Samaha, Y, Brazio P.S. Post-traumatic lymphedema: review of the literature and surgical treatment options. Plastic and Aesthetic Research. 2022; 9: 18.
4. 4. Warren, A.G, Brorson, H, Borud, L.J, Slavin, S,A. Lymphedema: a comprehensive review. Annals of plastic surgery, 2017, 59(4), 464–472.
5. 5. Ramaiah, K,D, Ottesen, E,A. Progress and impact of 13 years of the global programme to eliminate lymphatic filariasis on reducing the burden of filarial disease. PLoS neglected tropical diseases, 2014, 8(11), e3319.
6. 6. Lessiani, G, Iodice, P, Nicolucci, E, Gentili, M. Lymphatic edema of the lower limbs after orthopedic surgery: results of a randomized, open-label clinical trial with a new extended-release preparation. Journal of biological regulators and homeostatic agents, 2015 29(4), 805–812.
7. 7. Szuba, A, Rockson, S.G. Lymphedema: anatomy, physiology and pathogenesis. Vascular medicine (London, England), 1997, 2(4), 321–326.
8. 8. Wagner, J.M, Grolewski, V, Reinkemeier, F, Drysch, M, Schmidt, S.V, Dadras, M, Huber, J, Wallner, C, Sogorski, A, von Glinski, M, Schildhauer, T.A, Lehnhardt, M, Behr, B. Posttraumatic Lymphedema after Open Fractures of the Lower Extremity-A Retrospective Cohort Analysis. Journal of personalized medicine, 2021, 11(11), 1077.

9. 9. Thomas, C, Le, J.T, Benson, E. Managing Lymphedema in Fracture Care: Current Concepts and Treatment Principles. The Journal of the American Academy of Orthopaedic Surgeons, 2020, 28(18), 737–741.