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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2015 Sep 04


lingua: Inglese

Synergic effect of erysipelas on aggression to the lymphatic system in patients submitted to the excision of a saphenous vein

Quilici Belczak C. E. 1, Pereira de Godoy J. M. 2, Quilici Belzack S. 3, de Moraes Silva M. A. 4, Caffaro R. A. 5

1 Professor of Course Post Graduation of Lymphovenous Rehabilitation in Medicine School of São Jose do Rio Preto-FAMERP-Brazil;
2 Cardiology and Cardiovascular Surgery Department of the Medical School in São José do Rio Preto (FAMERP) and CNPq (National Council for Research and Development), Brazil;
3 Post graduation course in University of São Paulo (USP)-Brazil;
4 Physician of Vascular and Endovascular Surgery in Hospital Santa Marcelina, SP, Brazil;
5 Professor in Medical Science School of Santa Casa de São Paulo (FCMSCSP) Brazil


The aim of this study was to evaluate lymphoscintigraphic changes in patients who developed erysipelas after saphenous vein stripping. Lymphoscintigraphic changes related to erysipelas were evaluated in a retrospective, cross-sectional and quantitative study of 21 saphenectomy patients. Patients with infections, those weighing over 120 kg, with chronic arterial disease or heart failure were excluded from the study. A control group was formed of 21 patients submitted to saphenectomies matched by age and gender but with no history of erysipelas. All patients underwent lymphoscintigraphy of both legs. The Fisher’s exact and chi-square tests were used for statistical analysis with an alpha error of 5% being considered acceptable. Associations of dermal reflux and popliteal lymph nodes with erysipelas were observed in operated patients compared to non-operated patients (p-value = 0.002 and 0.03, respectively). Semiquantitative analysis showed a variation in the Kleinhans transport indexes of 0.15 to 20.5 for the entire sample. Group I showed a mean semiquantitative index of 2.42 (0.3 to 14.5), Group II of 3.15 (0.225 to 15.125) and Group III of 10.2 (0.15 to 38.25). The comparison of semiquantitative indexes of the groups by chi-square analysis showed that there was a statistically significant difference between the first two groups (I and II) and Group III (p-value < 0.05). Erysipelas is a synergistic mechanism of injury of the lymphatic system in patients submitted to saphenectomies.

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