Defining the Lymphatic System of the Anterior Abdominal Wall
| Autor: | J. Peter Rubin, Joseph Michaels, Amal Kanbour-Shakir, Devin Coon, Tali Friedman |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Abdominoplasty business.industry medicine.medical_treatment Abdominal Wall H&E stain Anatomy Fascia medicine.disease Lymphatic System Abdominal wall Plastic surgery medicine.anatomical_structure Lymphatic system Dermis Seroma medicine Humans Surgery Radiology business Lymphatic Vessels |
| Zdroj: | Plastic and Reconstructive Surgery. 135:1027-1032 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000001136 |
| Popis: | BACKGROUND Studies describing recent abdominoplasty modifications have reported a decreased incidence of seroma, attributed to preservation of abdominal lymphatics. However, there are limited anatomical data to support this hypothesis. The authors sought to characterize the lymphatic architecture of the abdominal wall and provide a conceptual basis for further refinement of abdominoplasty techniques. METHODS Fifteen tissue samples from five patients undergoing abdominoplasty were sectioned and analyzed. Slides were stained with hematoxylin and eosin, CD31, and D2-40 and assessed by a pathologist and a plastic surgeon for the presence and number of lymphatics. Results were reported as mean percentage of lymphatic-specific antibody per analyzed area. RESULTS Lymphatic vessels were observed in the dermis, superficial fascia, and loose areolar tissue but not in deep or superficial fat. The highest concentration was in the dermis (mean, 82.6 percent; range, 69 to 89.2 percent). The Scarpa fascia contained 9.4 percent of lymphatics (range, 7.0 to 11.4 percent), whereas the loose areolar tissue at the specimen base contained an average of 7.9 percent (range, 2.6 to 19.5 percent). These lymphatics were consistently located in the deepest third, with the Scarpa fascia lying an average of 34 percent of the total tissue thickness above muscle fascia. Lymphatic prevalence did not increase in specimens near the superficial epigastric vessels. CONCLUSIONS Abdominoplasty flap lymphatics are most common in the dermis, with a significant proportion (approximately 17 percent) also appearing near fascial layers. This confirms the presence of deep lymphatic channels that could potentially be preserved during abdominoplasty or lipoabdominoplasty. |
| Databáze: | OpenAIRE |
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