Lymphatic complications after lower limb vascular surgery

: A series of five patients with lymph fistula and two with lymphocele is described. Lymphatic complications in the groin and thigh following infrainguinal arterial surgery may increase the risk of wound infection and prolong the stay in hospital. During operation for lymph fistula and lymphocele, precise identification of the site of lymph leakage during exploration of the wound is mandatory. This can be obtained by intradermal injection of Patent blue 2.5% medially and laterally on the dorsum of the foot approximately one hour before operation. Operation for lymph fistula should be performed as soon as the diagnosis has been verified, especially if a prosthetic graft has been used. A lymphocele should be treated conservatively unless the patient is suffering from localized pain or ischemia of the skin caused by pressure of the underlying swelling.