The surgical management of elephantiasis of the lower extremeties

ABSTRACT

The etiological factors and historical data on surgical treatment of elephantiasis are briefly discussedIndications of operation by clinical criteria are the following a. Progressive increase in the size of the extremity especially despite conservative management for 6-12 monthsb. Marked skin changes such as in duration, thickening, hyperkeratosis, and dermatitisc. Repeated episodes of lymphangitis and chronic fungus infectiond. The unsightly appearance, the functional disability, and the severe reaction of the patient to the disease are obviouse. Tremendous increase in the size of the extremity affected so that the patient can hardly carry itDiagnosis of the lesion is often easily made; however, it is the etiological factor that is sometimes difficult to determine or prove. Not all cases that develop elephantiasis are due to filariasis. Most of them can be traced to lymphangitisSome of the improvements in the current surgical management of elephantoid extremities are briefly discussed. The use of full-thickness skin grafts and the avoidance of scar in kinetic areas is emphasizedThe operative procedure in one stage, the pre-operative preparation and postoperative care are discussedThe surgical treatment of choice at present in the Philippine General Hospital for elephantiasis of the lower extremities is the total excision of the edematous tissue (dermo-fibrolipectomy) and followed by skin grafting from the specimen and from the sound skin of the bodySix cases of elephantiasis of the lower extremity treated in the P.G.H. are presentedComplications and early results of the cases are discussedThe shorter the duration of the elephantiasis, the better is the result. (Summary)