Chinese Journal of Clinical Anatomy >
Applied anatomy of superficial lymphatic distribution of the foot and toes
Received date: 2014-09-09
Online published: 2014-12-04
Objective To determine the superficial lymphatic anatomy of the foot for clinic applications. Methods Four feet harvested from two unembalmed human cadavers were studied. Under a surgical microscope, a mixture of 6% hydrogen peroxide was used to detect lymphatic vessels commencing on bilateral sides of each toe and the foot edge. The collecting lymphatic vessel was found beneath the dermis. A 30-gauge needle was inserted and injected with a radio-opaque barium sulphate mixture. The vessels were traced, photographed and radiographed to demonstrate the lymphatic distribution and the relationship with the superficial veins of the foot. Results Each toe contained two lymph collecting vessels, one on each side. The mean vessel diameter was 0.5 mm. An average of fourteen lymph collecting vessels were found in the subcutaneous tissue of the dorsum of the foot. The mean vessel diameter was 0.6 mm. They were the continuation of lymph vessels arising from the toes, the medial and the lateral borders of the foot. There were a few vessels (mean 2, range 1 to 4) were distributed in the posterior aspect of the foot, arising from the sides of the Achilles tendon bilaterally in the subcutaneous tissue just above the heel. Lymphatic vessels of the foot travelled in a meandering fashion within the subcutaneous tissue and passed over and/or under the veins where they met. Conclusion Actual and accurate superficial lymphatic distribution of the foot has been described. This information upgrades the knowledge of the lymphatic anatomy and the results will be of bene?t for clinical management and further studies in the region.
Key words： Lymphatic vessel; Foot; ymphedema; Lymphovenous anastomosis; Lymphatic skin flap
CENG Fan-Jiang , BO Wei-Ren , WANG De-An . Applied anatomy of superficial lymphatic distribution of the foot and toes[J]. Chinese Journal of Clinical Anatomy, 2014 , 32(6) : 655 -658 . DOI: 10.13418/j.issn.1001-165x.201
[1] Aselli G. De lactibus sine lacteis venis
[M]. Milan: Italy, 1627.
[2] Pequet J. Experimenta Nova Anatomica
[M]. Paris. 1651.
[3] Nuck A. Adenographia curiosa et uteri foeminei anastome nova
[M]. Lugduni Betavorum, P. vandes Aa. 1692.
[4] Cruikshank W. The anatomy of the absorbing vessels of the human body
[M]. London: G. Nicol, 1786.
[5] Mascagni P. Vasorum lymphaticorum corporis humani historia et ichnographia
[M]. Sienna: P. Carli, 1787.
[6] Bonamy C, Broca P, Beau ME. Atlas d’anatomie descriptive du corps humain
[M]. Paris: Victor Masson, 1850.
[7] Sappey PC. Anatomie, Physiologie, Pathologie des vaisseaux lymphatiques
[M]. Paris: Adrien Delahaye, 1874.
[8] Haagensen CD, Feind CR, Herter FP, et al. The lymphatics in cancer
[M]. WB Saunders, Philadelphia 1972.
[9] Gerota D. Zur technik der lymphgefassinjection. Eine neue injections-masse fur lymphgefasse. Polychrom injection
[J]. Anat Anzeiger, 1896, 12: 216-224.
[10] Bartel B. Das Lymphgefasssystem. In Handbuch der Anatomie des Menschen
[M]. Edited by Kv Bardeleben. Jene: Gustav Fischer, 1909.
[11] Rouvière H. Anatomy of the human lymphatic system
[M]. Translated by Tobias MJ. Edwards Brothers Inc. Michgan, USA 1938.
[12] 王云祥. 实用淋巴系统解剖学
[M]. 北京：人民卫生出版社，1984:142-149.
[13] 刘执玉，毕玉顺，田华,等. 淋巴的基础与临床
[M]. 北京：科学出版社，2003：38-41.
[14] Pan WR, le Roux CM, Levy SM. Alternative lymphatic drainage routes from the lateral heel to the inguinal lymph nodes: anatomic study and clinical implicationsans
[J]. ANZ J Surg, 2010, 81(6): 431-435.
[15] Pan WR, Wang DG, Levy SM, et al. Superficial lymphatic drainage of the lower extremity: anatomic study and clinical implications
[J]. Plast Reconstr Surg, 2013, 132(3): 696-707.
[16] 程国良，潘达德. 手指再植与再造
[M].北京: 北京人民出版社. 1997:1-3，118-127，227-228.
[17] Buncke GM, Buncke HJ, Lee CK. Great toe-to-thumb microvascular transplantation after traumatic amputation
[J]. Hand Clin, 2007, 23(1):105-115.
[18] 侯书健，程国良，方光荣,等. 拇指及手指再造手术血管危象164 例临床分析
[J].中华显微外科，2005, 28(2):130-132.
[19] Taylor GI, Pan WR. The angiosome concept and tissue transfer
[M]. Quality Medical Publishing Inc. Missour, USA. 2014: 46-7,458-460, 581-582.
[20] Huang GK, Hu RQ, Liu ZZ, et al. Microlymphaticovenous anastomosis in the treatment of lower limb obstructive lymphedema: analysis of 91 cases
[J]. Plast Reconstr Surg, 1985, 76(5): 617-77.
[21] Baumeister R, Siuda S. Treatment of lymphedemas by microsurgical lymphatic grafting : what is proved
[J]? Plast Recon Surg, 1990, 85(1): 64-74.
/
| 〈 |
|
〉 |
