Possibilities of using modern visualization methods of the lymphatic system in plastic surgery

ABSTRACT

Lymphatic system (LS) visualization methods which are safe and satisfy the requirements of clinicians are very crucial. Currently, more sensitive devices appear and new methods have been introduced. This paper provides a comprehensive analysis of the main existing methods of LS visualization, indicating the possibilities of application in clinical and experimental conditions, presenting the advantages and disadvantages of the methods. There are two groups of LS visualization methods in general: direct or invasive (lymphangioscintigraphy) and indirect or minimally invasive (magnetic resonance, radionuclide, ultrasound, fluorescence). The features of the methods are: sensitivity, extension, specificity, and depth of penetration into tissues. This literature review gives a description of contrast agents and methods through which it is possible to visualize the dynamic status of lymphatic drainage and determine the localization of sentinel lymph nodes. We describe the most acceptable visualization method for use in plastic surgery to lower the rate of complications such as edema, bruising and inflammation.