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December 1979

Management of Lymph Fistula in the Groin After Arterial Reconstruction

Author Affiliations

From the Department of Surgery, University of California at Irvine; and the Veterans Administration Medical Center, Long Beach, Calif.

Arch Surg. 1979;114(12):1416-1418. doi:10.1001/archsurg.1979.01370360070008

• Leakage of lymph from the inguinal incision is a rare but disturbing complication of arterial surgery. This article describes our experience in the management of 12 patients in whom lymphorrhea developed following arterial reconstruction. Seven patients were treated with pressure dressings, antibiotics, and immobilization. In this group, fistula healing was delayed up to four weeks, and wound infection occurred in three of seven patients. One patient eventually required removal of the prosthetic graft and below-knee amputation. Early groin reexploration and direct ligature of ruptured lymphatics was performed in the remaining five patients. Hospitalization was shortened and wound infection prevented in all patients in this group. We recommend prompt operative closure as the preferred approach in the management of lymph fistula following vascular reconstruction, especially when synthetic graft material is present.

(Arch Surg 114:1416-1418, 1979)