[Research progress of lymphaticovenous anastomosis in treatment of severe extremity trauma].

Objective: To review the research progress of lymphaticovenous anastomosis (LVA) in the treatment of severe extremity trauma and prospect its clinical application prospects. Methods: Based on the existing literature, this study elaborated on the pathological mechanism and adverse effects of post-traumatic lymphatic drainage disorder, systematically sorted out the clinical research cases and therapeutic effects of LVA in the treatment of severe extremity trauma, and analyzed the limitations of the current clinical application of LVA. Results: Severe extremity trauma can cause extensive disruption of superficial and deep lymphatic vessels, which exacerbates post-traumatic limb swelling in the early stage and easily progresses to chronic lymphedema in the long term, thus hindering the process of wound repair and reducing patients' quality of life. Existing small-sample clinical studies and cases have confirmed that LVA can effectively reconstruct the lymphatic drainage pathway and exert a definite therapeutic effect on post-traumatic lymphedema. However, this technique is still in the early stage of clinical application, with unsolved problems including no consensus on the optimal application timing, incompletely elucidated underlying mechanism of action, and relatively high technical threshold. Conclusion: LVA exhibits important clinical application potential in the treatment of severe extremity trauma, and can serve as an effective method for clinically controlling limb swelling caused by post-traumatic lymphatic stasis. In the future, research should focus on the early therapeutic application of LVA for extremity trauma, clarify its optimal intervention timing and indications, optimize the treatment regimen by combining with traditional detumescence measures, so as to further enhance its clinical value in the treatment of severe extremity trauma.