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International Angiology 2017 August;36(4):382-5

DOI: 10.23736/S0392-9590.17.03446-0


language: English

Erysipelas as an aggravating factor for impaired lymphatics in saphenectomy patients

Cleusa E. QUILICI BELCZAK 1, José M., PEREIRA de GODOY 2, 3 , Sergio QUILICI BELCZAK 4, Melissa A., de MORAES SILVA 5, Roberto A. CAFFARO 6

1 Department of Lymphovenous Rehabilitation, Medicine School of São Jose do Rio Preto, São Jose do Rio Preto, Brazil; 2 Department of Cardiology and Cardiovascular Surgery, Medical School of São José do Rio Preto, São Jose do Rio Preto, Brazil; 3 CNPq (National Council for Research and Development), Brasilia, Brazil; 4 University of São Paulo, São Paulo, Brazil; 5 Department of Vascular and Endovascular Surgery, Hospital Santa Marcelina, São Paulo, Brazil; 6 Department of Medical Sciences, School of Santa Casa de São Paulo, São Paulo, Brazil


BACKGROUND: The aim of this study was to evaluate lymphoscintigraphic changes in patients who developed erysipelas after saphenous vein stripping.
METHODS: 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 χ2 tests were used for statistical analysis with an alpha error of 5% being considered acceptable.
RESULTS: 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 χ2 analysis showed that there was a statistically significant difference between the first two groups (I and II) and group III (P value <0.05).
CONCLUSIONS: Erysipelas is a synergistic mechanism of injury of the lymphatic system in patients submitted to saphenectomies.

KEY WORDS: Lymphoscintigraphy - Erysipelas - Saphenous vein - Lymphedema

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