Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;51(10):1630-1637.
doi: 10.1007/s00595-021-02283-9. Epub 2021 May 16.

Combined internal and external negative pressure wound therapy: breakthrough treatment for lymphocutaneous intractable fistula

Takahiro Miura  1 , Yuhei Yamamoto  1 , Naoki Murao  1 , Taku Maeda  1 , Masayuki Osawa  1 , Toshihiko Hayashi  1 , Emi Funayama  2
Affiliations

Combined internal and external negative pressure wound therapy: breakthrough treatment for lymphocutaneous intractable fistula

Takahiro Miura et al. Surg Today. 2021 Oct.

Abstract

Purpose: Lymphocutaneous fistula after lymph node dissection is intractable, yet there is no established treatment strategy. This study demonstrates the wound closure time achieved by a new method of combined internal and external negative pressure wound therapy (CIEN) in patients with lymphocutaneous fistula.

Methods: The subjects of this study were six consecutive patients with lymphocutaneous fistula after lymphatic surgery, who were treated with CIEN between 2018 and 2020. The CIEN technique can be summarized as follows: first, internal foam is inserted into the fistula from the opening of the fenestration. Next, a slightly larger area of external foam is applied above the fistula flap outside the external margin of the foam-filled fistula. After bridging the internal foam and external foam, negative-pressure wound therapy is carried out on this bridging foam block.

Results: CIEN led to rapid and complete wound healing in all six patients. Fistula flap margin ischemia developed in one patient, but adjusting the mode and pressure settings resulted in improvement. Three patients suffered contact dermatitis. There were no signs of tumor or fistula recurrence in any patients after at least 3 months of follow-up.

Conclusion: CIEN is an effective and less invasive treatment modality than the conventional method of managing lymphocutaneous fistula.

Keywords: Lymph node dissection; Lymphocutaneous fistula; Negative pressure wound therapy.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Greer SE, Adelman M, Kasabian A, Galiano RD, Scott R, Longaker MT. The use of subatmospheric pressure dressing therapy to close lymphocutaneous fistulas of the groin. Br J Plast Surg. 2000;53:484–7. - DOI
    1. Dosluoglu HH, Schimpf DK, Schultz R, Cherr GS. Preservation of infected and exposed vascular grafts using vacuum assisted closure without muscle flap coverage. J Vasc Surg. 2005;42:989–92. - DOI
    1. Abai B, Zickler RW, Pappas PJ, Lal BK, Padberg FT Jr. Lymphorrhea responds to negative pressure wound therapy. J Vasc Surg. 2007;45:610–3. - DOI
    1. Cai SS, Gowda AU, Alexander RH, Silverman RP, Goldberg NH, Rasko YM. Use of negative pressure wound therapy on malignant wounds—a case report and review of literature. Int Wound J. 2017;14:661–5. - DOI
    1. Porcellini M, Iandoli R, Spinetti F, Bracale U, di Lella D. Lymphoceles complicating arterial reconstructions of the lower limbs: outpatient conservative management. J Cardiovasc Surg. 2002;43:217–21.

LinkOut - more resources