Elective amputation of the toes in severe lymphedema of the lower leg

Rationale and indications

Hung Chi Chen, Bahar Bassiri Gharb, Christopher Salgado, Antonio Rampazzo, Enny Xu, Stefano Spanio Di Spilimbergo, Syi Su

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Entry lesions at the toes interdigital spaces, in the setting of chronic lymphedema, are strongly associated with repetitive infective episodes which cause significant morbidity. A prospective study was designed to evaluate the outcome in 2 groups of patients affected by end stage III lymphedema of the lower extremity, treated with the Charles procedure with or without simultaneous amputation of the toes. At a mean 3 years of follow-up, 20% of the patients receiving elective toes amputation experienced recurrence of the infection and none required more proximal amputations. Among the patients not desiring elective toes amputation; 83% suffered multiples attacks of cellulitis and in 88% the toes were eventually amputated. The difference in the number of infective episodes between the 2 groups was highly significant. No cases of recurrent lymphedema were registered. Elective toes amputation in combination with the Charles procedure reduces recurrent cellulitis and long-term morbidity in stage III lymphedema of the lower leg.

Original languageEnglish
Pages (from-to)193-197
Number of pages5
JournalAnnals of Plastic Surgery
Volume63
Issue number2
DOIs
StatePublished - Aug 1 2009
Externally publishedYes

Fingerprint

Lymphedema
Toes
Amputation
Leg
Cellulitis
Morbidity
Lower Extremity
Prospective Studies
Recurrence
Infection

Keywords

  • Charles procedure
  • Limb salvage
  • Lymphedema
  • Toes amputation

ASJC Scopus subject areas

  • Surgery

Cite this

Chen, H. C., Gharb, B. B., Salgado, C., Rampazzo, A., Xu, E., Di Spilimbergo, S. S., & Su, S. (2009). Elective amputation of the toes in severe lymphedema of the lower leg: Rationale and indications. Annals of Plastic Surgery, 63(2), 193-197. https://doi.org/10.1097/SAP.0b013e31818c4ab6

Elective amputation of the toes in severe lymphedema of the lower leg : Rationale and indications. / Chen, Hung Chi; Gharb, Bahar Bassiri; Salgado, Christopher; Rampazzo, Antonio; Xu, Enny; Di Spilimbergo, Stefano Spanio; Su, Syi.

In: Annals of Plastic Surgery, Vol. 63, No. 2, 01.08.2009, p. 193-197.

Research output: Contribution to journalArticle

Chen, HC, Gharb, BB, Salgado, C, Rampazzo, A, Xu, E, Di Spilimbergo, SS & Su, S 2009, 'Elective amputation of the toes in severe lymphedema of the lower leg: Rationale and indications', Annals of Plastic Surgery, vol. 63, no. 2, pp. 193-197. https://doi.org/10.1097/SAP.0b013e31818c4ab6
Chen, Hung Chi ; Gharb, Bahar Bassiri ; Salgado, Christopher ; Rampazzo, Antonio ; Xu, Enny ; Di Spilimbergo, Stefano Spanio ; Su, Syi. / Elective amputation of the toes in severe lymphedema of the lower leg : Rationale and indications. In: Annals of Plastic Surgery. 2009 ; Vol. 63, No. 2. pp. 193-197.
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