{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T03:39:11Z","timestamp":1775705951825,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"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":["Microsurgery"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recent studies have analyzed the combination of suction\u2010assisted lipectomy (SAL) and vascularized lymph node transfer (VLNT) in lymphedema treatment, reporting positive outcomes. However, it is difficult to draw conclusions due to the heterogeneity of the studies. Aim of this prospective study is to evaluate the effectiveness of the combination of VLNT and SAL in lymphedema treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Between January 2016 and May 2019, 94 patients with upper or lower limb stage IIb\u2010III lymphedema were enrolled and treated with the gastroepiploic VLNT followed by SAL. Patients were prospectively evaluated through circumference measurement and clinical examination, including number of episodes of cellulitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among patients enrolled in the study 83 were affected by lower limb lymphedema (LLL) and 11 were affected by upper limb lymphedema (ULL). Average follow\u2010up was 3\u2009\u00b1\u20090.8\u2009years. In the LLL group, the mean circumference reduction rates (CRR) were 60.4, 56.9, 29.6, and 55.4% above and below the knee, above the ankle, and at the foot level, respectively. A statistically significant difference was noted at all the levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), but above the ankle (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.059). Regarding the ULL group, the mean CRR were 80.7, 60.7, 65.0 and 49.6% above and below the elbow, at wrist and at mid\u2010hand, respectively. CRR were reported at all the levels but no statistical difference was noted. The number of episodes of cellulitis dropped significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study supports the use of VLNT+SAL in lymphedema grades IIb\u2010III, with important implications for the clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30855","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T11:54:54Z","timestamp":1641556494000},"page":"433-440","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Combined lymph node transfer and suction\u2010assisted lipectomy in lymphedema treatment: A prospective study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6418-2873","authenticated-orcid":false,"given":"Alberto","family":"Bolletta","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital  Taichung Taiwan"},{"name":"Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3014-2419","authenticated-orcid":false,"given":"Giuseppe","family":"di Taranto","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital  Taichung Taiwan"},{"name":"Plastic Surgery Unit, Department of surgery Sapienza University of Rome  Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9105-1839","authenticated-orcid":false,"given":"Luigi","family":"Losco","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital  Taichung Taiwan"},{"name":"Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":"Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation University of Bari  Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8005-5049","authenticated-orcid":false,"given":"Gokhan","family":"Sert","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Ribuffo","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Department of surgery Sapienza University of Rome  Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Cigna","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung\u2010Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery China Medical University Hospital  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24969"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25583"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30327"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2018.12.018"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2019.02.009"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002683"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24383"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30753"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30736"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30745"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30508"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2020.01.14"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24349"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-2017-4"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01019.2013"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.26355\/eurrev_202004_21030"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.26355\/eurrev_202008_22486"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30641"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25767"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25581"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25257"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.6096"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng1642"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/elps.201500504"},{"issue":"1","key":"e_1_2_10_26_1","first-page":"1","article-title":"The diagnosis and treatment of peripheral lymphedema: 2013 consensus document of the International Society of Lymphology","volume":"46","author":"International Society of Lymphology","year":"2013","journal-title":"Lymphology"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.26355\/eurrev_201905_17955"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001828"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25234"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-019-01543-x"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0070"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2019.01.029"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30511"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1578814"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-015-1736-3"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2016.06.022"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2016.06.022"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000763"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-020-01892-y"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30079"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004506"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30256"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30855","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.30855","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:25:46Z","timestamp":1692836746000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.30855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,7]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1002\/micr.30855"],"URL":"https:\/\/doi.org\/10.1002\/micr.30855","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,7]]},"assertion":[{"value":"2021-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}