Optimizing outcome of charles procedure for chronic lower extremity lymphoedema

Ann Plast Surg. 2011 Apr;66(4):393-402. doi: 10.1097/SAP.0b013e3181d6e45e.

Abstract

Background: The Charles procedure for late-stage lower limb lymphoedema (LLL) is often criticized for its unpredictable and poor results. We have adopted a systematic approach to optimize outcome of patients treated with this excisional surgery.

Methods: From June 2004 to March 2009 we performed the Charles procedure on 1 lower limb of 19 women and 8 men with late-stage LLL. Mean age and follow-up was 48 (range, 16.5-77.8) years and 21.6 (range, 1.5-48) months, respectively.

Results: Average inpatient stay was 27 (range, 11-54) days. After discharge, 16 (59.3%) patients underwent further minor surgery. The most frequent complication was a single, short episode of cellulitis, affecting 5 (18.5%) patients. Self-reported mobility was either the same or improved at 6 months, and appearance of their limbs satisfactory.

Conclusions: The Charles procedure is an effective treatment for selected patients and by applying our systematic approach, a positive outcome can be achieved.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Leg / pathology
  • Leg / surgery*
  • Lymphedema / pathology
  • Lymphedema / surgery*
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Recovery of Function
  • Retrospective Studies
  • Risk Factors
  • Skin Transplantation*
  • Surgical Flaps*
  • Taiwan
  • Treatment Outcome
  • Young Adult