Diabetic Foot Ulcers Combination with Lower Limb Lymphedema Treated by Staged Charles Procedure: Case Report and Literature Review

Primary or secondary, lymphedema is lymphatic dysfunction which results in protein-rich interstitial fluid accumulated in the skin and subcutaneous tissue. In developed countries, surgical resection of regional lymph nodes or chronic inflammation process is the most common etiology of lymphedema instead of parasite infection seen in developing countries. Patients with lymphedema sustain either cosmetic or functional problems, and several studies have indicated the potential risk, though not high, transforming lymphedema to lymphangiosarcoma. Here we introduce a simple idea with staged Charles procedure by a case report to decrease the size of wound healing in each procedure and decreasing the rate of surgical complication.