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Optimizing Outcome of Charles Procedure for Chronic Lower Extremity Lymphoedema

Karri, Vasu BSc(Hons), MRCS, MSc*; Yang, Ming-Chin PhD; Lee, Il Jae MD, PhD; Chen, Shih-Heng MD*; Hong, Joon Pio MD, PhD, MMM§; Xu, Enny-Sonia MS*; Cruz-Vargas, Jaqueline MD*; Chen, Hung-Chi MD, FACS

doi: 10.1097/SAP.0b013e3181d6e45e
Reconstructive Surgery
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Background: The Charles procedure for late-stage lower limb lymphoedema (LLL) is often criticized for its unpredictable and poor results. We have adopted a systematic approach to optimize outcome of patients treated with this excisional surgery.

Methods: From June 2004 to March 2009 we performed the Charles procedure on 1 lower limb of 19 women and 8 men with late-stage LLL. Mean age and follow-up was 48 (range, 16.5–77.8) years and 21.6 (range, 1.5–48) months, respectively.

Results: Average inpatient stay was 27 (range, 11–54) days. After discharge, 16 (59.3%) patients underwent further minor surgery. The most frequent complication was a single, short episode of cellulitis, affecting 5 (18.5%) patients. Self-reported mobility was either the same or improved at 6 months, and appearance of their limbs satisfactory.

Conclusions: The Charles procedure is an effective treatment for selected patients and by applying our systematic approach, a positive outcome can be achieved.

From the *Department of Plastic and Reconstructive Surgery, E-Da Hospital/I-Shou University, Kaohsiung County; †Department of Public Health, Institute of Health Organization Administration, College of Public Health, National Taiwan University, Taiwan, Republic of China; ‡Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Suwon City; §Department of Plastic and Reconstructive Surgery, Asan Medical Center, Seoul, South Korea; and ¶China Medical University Hospital, Taichung, Taiwan, Republic of China

Received October 1, 2009, and accepted for publication, after revision, January 31, 2010.

This article is attributed to the Department of Plastic and Reconstructive Surgery, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China.

Reprints: Hung-Chi Chen, MD, FACS, Department of Plastic and Reconstructive Surgery, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China. E-mail: Ed100002@edah.org.tw.

© 2011 Lippincott Williams & Wilkins, Inc.