与皮肤灌注不足和溃疡相关的脂水肿:软组织减积改善皮肤灌注

IF 1.3 Q3 SURGERY
Feras Alshomer, Seok Joon Lee, Yeongsong Kim, Dae Won Hong, Changsik John Pak, Hyunsuk Peter Suh, Joon Pio Hong
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引用次数: 0

摘要

简介:脂肪水肿是一种进行性结缔组织疾病,伴有脂肪组织扩大、纤维化、积液和真皮增厚。在此,我们提出一个与皮肤灌注不足和溃疡相关的脂肪水肿病例,其中软组织减容和吸脂术改善了患者的症状。病例介绍:一名39岁女性,最初表现为不对称进行性单侧下肢肿胀,伴有剧烈疼痛,随后出现皮肤溃疡。保守治疗未能改善她的病情。在排除其他原因和详细的放射学调查后,脂水肿被诊断为相关的皮肤灌注受损。局部创面护理和压迫治疗未能改善病情。随后的软组织减容术和周围吸脂术以及溃疡清创和立即压迫显示症状和皮肤灌注的显著改善。讨论:本病例的独特性质揭示了脂水肿作为一种松散结缔组织疾病。炎症和微血管病变解释了与灌注不足和溃疡相关的疼痛是相当不典型的,部分可能与基质蛋白和钠含量的大量积聚有关,导致微血管脆弱,经常出现瘀点和血肿,随后出现组织缺血。保守治疗如压迫治疗在病程中起重要作用。手术减脂与吸脂被证明是有效的减少软组织负荷,改善肢体疼痛,水肿,围度和皮肤灌注在我们的病人。结论:脂肪水肿是一种常被误诊的具有致残特征的疾病。脂水肿伴潜在灌注不足的皮肤受累,需要进一步调查
本文章由计算机程序翻译,如有差异,请以英文原文为准。
LIPEDEMA ASSOCIATED WITH SKIN HYPOPERFUSION AND ULCERATION: SOFT TISSUE DEBULKING IMPROVING SKIN PERFUSION
INTRODUCTION: Lipedema is a progressive connective tissue disease with enlargement of adipose tissue, fibrosis, fluid collection and dermal thickening. Herein, we present a case of lipedema associated with skin hypoperfusion and ulceration in which soft tissue debulking with liposuction improved patients’ symptoms. CASE PRESENTATION: A 39-year-old female presented with asymmetric progressive initially unilateral lower limb swelling with severe pain with subsequent skin ulceration. Conservative management have failed to improve her condition. After excluding other causes and detailed radiologic investigation, lipedema was diagnosed with an associated impaired skin perfusion. Trial of local wound care and compression therapy failed to improve the condition. Subsequent soft tissue debulking with circumferential liposuction and ulcer debridement and immediate compression showed dramatic improvement of the symptoms and skin perfusion. DISCUSSION: The unique nature of this case shed light on lipedema as a loose connective tissue disease. Inflammation and microangiopathies explains the associated pain with hypoperfusion and ulceration being quite atypical and in part might be related to the large buildups of matrix proteins and sodium contents leading to micro-vessels fragility with frequent petechiae and hematoma and subsequent tissue ischemia. Conservative measures like compression therapy plays a significant role in disease course. Surgical debulking with liposuction was shown to be efficacious in reducing the soft tissue load with improvement in limb pain, edema, circumference and skin perfusion that was seen in our patient. CONCLUSION: Lipedema is a frequently misdiagnosed condition with disabling features. Skin involvement in lipedema with potential hypoperfusion was shown and it requires further investigation
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来源期刊
CiteScore
2.10
自引率
6.70%
发文量
131
审稿时长
10 weeks
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