Surgical Treatment – Past History

Unlike the current, effective surgical procedures, previous, surgical methods to treat Lymphedema have been radical and often ineffective. The resulting deformity many times was significantly worse than the original Lymphedema. Complications were also numerous and included necrosis of the transferred skin flaps, recurrence or worsening of the Lymphedema, permanent nerve damage, loss of extremity function and amputation.

The Charles procedure involved debulking of the extremity by debridement of the edematous skin and boggy subcutaneous tissue down to muscle and fascia. The overlying resected skin was used as a skin graft over the affected area. The resulting deformity often was worse than the original Lymphedema.

The Thompson procedure was similar but also involved retaining a debulked flap of skin in the extremity. This flap was thought to contain subdermal lymphatics to “wick” fluid to the deeper lymph channels.