Host-Reaction Following Silicone Tube Implantation For Lower Limb Lymphoedema Mimicking Implant Infection
Keywords:Lymphoedema, Silicone Tube Implantation, Host-reaction, Dermatolymphangioadenitis, Graft Infection
Introduction: Silicone tube implantation in lymphoedema reduces symptoms by improving fluid drainage. Although there are descriptions of implant host reaction that can be misdiagnosed as graft infections these are scarce.
Report: A 34 year old female with lymphoedema of the lower limb, underwent silicone tube implantation. Ten months after surgery, the patient presented with fever and dermatolymphangioadenitis of the limb. Ultrasound suggested an abscess surrounding the tubes. Clinical improvement was achieved after a 6-day cycle of meropenem. She was discharged under oral cefuroxime and clindamycin for one week. After 1 month, CT-angiography was performed showing only residual inflammation surrounding the tubes, the patient was asymptomatic and limb diameter was normal.
Conclusion: Sudden onset and improvement of the patient’s condition after a short cycle of antibiotics without the need of tube removal supports a host-like reaction rather than an actual infection. Doctors should be aware of such complications avoiding unnecessary procedures.
Sleigh BC, Manna B. Lymphedema [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https:// www.ncbi.nlm.nih.gov/books/NBK537239/
Fox SL. SOUTHEY TUBES IN MANAGEMENT OF LYMPHEDEMA OF ARM. Journal of the American Medical Association [Internet]. 1955 Jul 2 [cited 2022 Sep 3];158(9):775–5. Available from: https://jamanetwork.com/journals/jama/article-abstract/301281. DOI:10.1001/jama.1955.02960090069012
Weber EG, Budde R. [New aspects of the surgical treatment of chronic lymphedema]. Handchirurgie, Mikrochirurgie, Plastische Chirurgie: Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie: Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse: Organ Der V [Internet]. 1984 Mar 1 [cited 2022 Sep
;16(1):15–9. Available from: https://pubmed.ncbi.nlm.nih.
Paroni G, Rossi G, Chierichetti F, Guagliano A, Aloi T, Cugnasca
M. [Surgical treatment of post-mastectomy lymphedema of the upper limb]. Minerva Chirurgica [Internet]. 1996 May 1 [cited 2022 Sep 3];51(5):297–9. Available from: https://pubmed.ncbi.nlm.nih.gov/9072739/
Olszewski WL, Zaleska M. A novel method of edema fluid drainage in obstructive lymphedema of limbs by implantation of hydrophobic silicone tubes. J Vasc Surg Venous Lymphat Disord [Internet]. 2015 [cited 2022 Sep 3];3(4):401–8. Available from: https://pubmed.ncbi.nlm.nih.gov/26992618/. DOI:10.1016/j. jvsv.2015.05.001
Olszewski WL, Zaleska M. Treatment of postmastectomy lymphedema by bypassing the armpit with implanted silicone tubings. Int Angiol [Internet]. 2017 [cited 2022 Sep 3];36(1):50–8. Available from: https://pubmed.ncbi.nlm.nih.gov/26603434/. DOI:10.23736/S0392-9590.16.03630-0
Olszewski WL, Zaleska MT, Hydrabadi R, Banker M, Kurulkar P. Edema Fluid Can Be Successfully Evacuated from the Lymphedematous Limbs by Implantation of Silicone Tubings Bypassing the Site of Flow Obstruction Long-Term Observations. Lymphat- ic Research and Biology [Internet]. 2019 Oct 1 [cited 2022 Sep 3];17(5):557–64. Available from: https://pubmed.ncbi.nlm.nih. gov/30810455/. DOI:10.1089/lrb.2018.0042
How to Cite
Copyright (c) 2023 Portuguese Journal of Cardiac Thoracic and Vascular Surgery
This work is licensed under a Creative Commons Attribution 4.0 International License.