Development of an All-Wales National Health Service Surgical Lymphedema Supermicrosurgery Service

Background:. The management of lymphedema includes an array of conservative measures, but must also include surgical intervention as a management option where appropriate. Within the National Health Service in Great Britain, the surgical provision for lymphedema patients is very minimal. This articl...

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Main Authors: Ross Weale, MBBS, MRCS, BSc, Mia Thomas, MBBS, Cheryl Pike, DProf, MCSP, Melanie Thomas, MBE, DProf, FCSP, Zita M. Jessop, MA (Cantab), MB BChir, MRCS, PhD, Thomas Bragg, FRCS (Plast), Amar Ghattaura, MBBS, BSc, MSc, FRCS (Plast)
Format: Article
Language:English
Published: Wolters Kluwer 2025-04-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006672
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author Ross Weale, MBBS, MRCS, BSc
Mia Thomas, MBBS
Cheryl Pike, DProf, MCSP
Melanie Thomas, MBE, DProf, FCSP
Zita M. Jessop, MA (Cantab), MB BChir, MRCS, PhD
Thomas Bragg, FRCS (Plast)
Amar Ghattaura, MBBS, BSc, MSc, FRCS (Plast)
author_facet Ross Weale, MBBS, MRCS, BSc
Mia Thomas, MBBS
Cheryl Pike, DProf, MCSP
Melanie Thomas, MBE, DProf, FCSP
Zita M. Jessop, MA (Cantab), MB BChir, MRCS, PhD
Thomas Bragg, FRCS (Plast)
Amar Ghattaura, MBBS, BSc, MSc, FRCS (Plast)
author_sort Ross Weale, MBBS, MRCS, BSc
collection DOAJ
description Background:. The management of lymphedema includes an array of conservative measures, but must also include surgical intervention as a management option where appropriate. Within the National Health Service in Great Britain, the surgical provision for lymphedema patients is very minimal. This article provides a historical overview of the inception of the lymphedema service within Wales, which is the only holistic lymphedema service within the National Health Service. Methods:. All patients discussed at the lymphedema multidisciplinary team (MDT) meeting were included. Data were collected during a 5-year period from June 2017 to May 2022. MDT meeting outcomes were also recorded (conservative or surgical management), and if surgical intervention was used, the type of surgical procedure was documented. Results:. A total of 175 patients were discussed by the lymphedema surgical MDT. Of these, 129 (74%) were recommended for surgery and 46 (26%) were managed using conservative measures alone. The most common surgical recommendation was for lymphovenous anastomosis (61, 47%), followed by liposuction (40, 31%). Vascularized lymph node transfer was recommended in 19 (15%) cases. Conclusions:. The authors highlight the efficiency of the service, whereby despite more than 7500 referrals a year, only a small minority that are eligible for surgery undergo a surgical assessment. The authors hope that this article provides an impetus for such services to be similarly replicated across other nations.
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spelling doaj-art-eca5339873244b77bbdb47b77cc3ddfb2025-08-20T03:53:27ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-04-01134e667210.1097/GOX.0000000000006672202504000-00020Development of an All-Wales National Health Service Surgical Lymphedema Supermicrosurgery ServiceRoss Weale, MBBS, MRCS, BSc0Mia Thomas, MBBS1Cheryl Pike, DProf, MCSP2Melanie Thomas, MBE, DProf, FCSP3Zita M. Jessop, MA (Cantab), MB BChir, MRCS, PhD4Thomas Bragg, FRCS (Plast)5Amar Ghattaura, MBBS, BSc, MSc, FRCS (Plast)6From the Department of Plastic Surgery, Welsh Center for Burns and Plastic Surgery, Morriston Hospital, Morriston, Swansea, United Kingdom.From the Department of Plastic Surgery, Welsh Center for Burns and Plastic Surgery, Morriston Hospital, Morriston, Swansea, United Kingdom.From the Department of Plastic Surgery, Welsh Center for Burns and Plastic Surgery, Morriston Hospital, Morriston, Swansea, United Kingdom.From the Department of Plastic Surgery, Welsh Center for Burns and Plastic Surgery, Morriston Hospital, Morriston, Swansea, United Kingdom.From the Department of Plastic Surgery, Welsh Center for Burns and Plastic Surgery, Morriston Hospital, Morriston, Swansea, United Kingdom.From the Department of Plastic Surgery, Welsh Center for Burns and Plastic Surgery, Morriston Hospital, Morriston, Swansea, United Kingdom.From the Department of Plastic Surgery, Welsh Center for Burns and Plastic Surgery, Morriston Hospital, Morriston, Swansea, United Kingdom.Background:. The management of lymphedema includes an array of conservative measures, but must also include surgical intervention as a management option where appropriate. Within the National Health Service in Great Britain, the surgical provision for lymphedema patients is very minimal. This article provides a historical overview of the inception of the lymphedema service within Wales, which is the only holistic lymphedema service within the National Health Service. Methods:. All patients discussed at the lymphedema multidisciplinary team (MDT) meeting were included. Data were collected during a 5-year period from June 2017 to May 2022. MDT meeting outcomes were also recorded (conservative or surgical management), and if surgical intervention was used, the type of surgical procedure was documented. Results:. A total of 175 patients were discussed by the lymphedema surgical MDT. Of these, 129 (74%) were recommended for surgery and 46 (26%) were managed using conservative measures alone. The most common surgical recommendation was for lymphovenous anastomosis (61, 47%), followed by liposuction (40, 31%). Vascularized lymph node transfer was recommended in 19 (15%) cases. Conclusions:. The authors highlight the efficiency of the service, whereby despite more than 7500 referrals a year, only a small minority that are eligible for surgery undergo a surgical assessment. The authors hope that this article provides an impetus for such services to be similarly replicated across other nations.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006672
spellingShingle Ross Weale, MBBS, MRCS, BSc
Mia Thomas, MBBS
Cheryl Pike, DProf, MCSP
Melanie Thomas, MBE, DProf, FCSP
Zita M. Jessop, MA (Cantab), MB BChir, MRCS, PhD
Thomas Bragg, FRCS (Plast)
Amar Ghattaura, MBBS, BSc, MSc, FRCS (Plast)
Development of an All-Wales National Health Service Surgical Lymphedema Supermicrosurgery Service
Plastic and Reconstructive Surgery, Global Open
title Development of an All-Wales National Health Service Surgical Lymphedema Supermicrosurgery Service
title_full Development of an All-Wales National Health Service Surgical Lymphedema Supermicrosurgery Service
title_fullStr Development of an All-Wales National Health Service Surgical Lymphedema Supermicrosurgery Service
title_full_unstemmed Development of an All-Wales National Health Service Surgical Lymphedema Supermicrosurgery Service
title_short Development of an All-Wales National Health Service Surgical Lymphedema Supermicrosurgery Service
title_sort development of an all wales national health service surgical lymphedema supermicrosurgery service
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006672
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