{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:18:53Z","timestamp":1780499933682,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T00:00:00Z","timestamp":1559692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>In patients with lymphedema, the disruption of the lymphatic network increases skin turgor and fibrosis of subcutaneous tissue, delays wound healing, causing recurrent ulcerations and infections. In these cases, management of ulcers can be challenging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 2016 and June 2018, patients presenting with lymphedema were enrolled at our Institution. We selected patients with severe lymphedema and ulcers of lower limbs and we performed a surgical approach, involving free gastroepiploic lymph nodes and omentum flap, harvested through laparoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 135 patients presenting for lymphedema. Among them, 10 eligible cases underwent excision of the ulcer and reconstruction with omentum flap. Mean age was 57.8 years and average follow\u2010up 24.1 months. Circumferences and skin tonicity significantly decreased from the preoperative period. Lymphoscintigraphy showed improvement of the lymphatic drainage and restoration of lymphatic network. No episodes of infection were recorded in the postoperative period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our combined procedure merges free flap techniques and lymphedema surgery: omentum covers the defect while providing a new source of lymph nodes, improving the lymphatic networks of the affected limb. This technique can highly increase the quality of life of the patient in a single\u2010stage operation with fast recovery and low donor site morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25581","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T04:24:10Z","timestamp":1559795050000},"page":"168-174","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Free gastroepiploic lymph nodes and omentum flap for treatment of lower limb ulcers in severe lymphedema: Killing two birds with one stone"],"prefix":"10.1002","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3014-2419","authenticated-orcid":false,"given":"Giuseppe","family":"Di Taranto","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital Taichung Taiwan"},{"name":"Department of Plastic and Reconstructive Surgery Umberto I University Hospital Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Heng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Chang Gung Memorial Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6094-5159","authenticated-orcid":false,"given":"Rossella","family":"Elia","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital Taichung Taiwan"},{"name":"Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation University of Bari Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6418-2873","authenticated-orcid":false,"given":"Alberto","family":"Bolletta","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital Taichung Taiwan"},{"name":"Department of Medical, Surgical, and Experimental Sciences Plastic Surgery Unit University of Sassari Sassari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Amorosi","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital Taichung Taiwan"},{"name":"Plastic Surgery Department Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngamcherd","family":"Sitpahul","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital Taichung Taiwan"},{"name":"Department of Plastic and Maxillofacial Surgery, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey CY","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Ribuffo","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Umberto I University Hospital Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital Taichung 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