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Radical lymphadenectomy for malignant melanoma

Follow-up

Groin dissection:

  • The day of operation and 1. postoperative day the patient stays in bed (toilet leave prohibited).
  • 2. postoperative day the patient may move by wheel-chair and careful walking to the toilet. Gradually mobilization till normal within a week.
  • Thigh-long "white" stocking continuously during the hospital stay and every night for 3 months.
  • Thigh-long "brown" stocking every day for 6 months.

Axillary dissection:

  • The day of operation the patient stays in bed.
  • Mobilisation with mitella from 1. postoperative day.

The vacuum-drain (active) should be kept for 5-10 days or until the volume of fluid is reduced to 40-50 ml per 24 hours. The vacuum is neutralized and remains passive. At home the drain is shortened 1 cm daily by the nurse. This is to ensure that the wound heals from the inside- outwards.

Complications

  • Postoperative seromas – these are drained aseptically
  • Nerve pain and dysfunctions – often temporary
  • Edge necrosis, lymphedema, and incision infections – more frequent for inguinal dissection
  • Deep vein thrombosis in the leg

Lymphedema is a serious and persistent complication. Lymphedema after axilla dissection is rarely observed, but occurs in approximately 20% of patients after a groin dissection. 

After an inguinal dissection, it is recommended that for the first three months after the operation, the patient elevates their feet while lying and sitting. In the same period, it is recommended to use elastic stockings day and night. Gradual decrease in the use of stockings should take place during the next three months. After an axillary dissection, it is not necessary to routinely use elastic stockings.

Physiotherapy

Physiotherapy after the operation is important for the patient to achieve an adequate rehabilitation process. Many do not need to go to sessions of physiotherapy, but rather, information and guidance will be adequate.

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