The SKH Lymphoedema Service team is equipped with modern treatment modalities for lymphoedema and microsurgical reconstruction.
Lymphoedema is a condition characterised by swelling, usually in the arms or legs, due to a build-up of lymph fluid. It often occurs after lymph node removal or damage from cancer treatment, infections or injuries.
Modern treatments include compression therapy, manual lymphatic drainage, and surgery. Surgical options include lymphatic bypass, vascularised lymph node transfer, and liposuction. Lymphatic bypass is a technique that joins the lymphatic vessel to a vein, allowing the lymphatic fluid to bypass the obstruction. In vascularised lymph node transfer, healthy and viable nodes are transferred from an abundant area onto the affected limb, allowing new lymphatic vessels to grow and solve the issue of lymphatic obstruction. Liposuction is an important additional procedure to directly reduce the size of the limb.
In February 2023, Dr Allen Wong, Consultant, Plastic, Reconstructive and Aesthetics Service, Sengkang General Hospital (SKH), headed to Chang Gung Memorial Hospital in Linkou, Taiwan, for a year-long fellowship under the Singapore Ministry of Health’s Health Manpower Development Plan (HMDP) programme, together with a team of colleagues.
In line with the HMDP theme, ‘Comprehensive and Preventative Management of Lymphoedema, and Microsurgical Reconstruction’, the team trained in modern treatment modalities for lymphoedema, from prevention, diagnosis and treatment to long-term follow-up. They also learnt about the latest in microsurgical reconstruction, including how to set up and maintain a highvolume microsurgical reconstruction unit.
Under the HMDP programme, individuals who have identified a service need or gap in Singapore can prepare a proposal for a training centre that can address this service requirement. The SKH team, comprising operating theatre nurse Ms Feng Fangfang, Nurse Clinician Ms Teh Shi Yun from the High Dependency Unit, and Principal Physiotherapist Ms Phoebe Ting Su-Yuin, led by Dr Wong, trained at the world-renowned plastic surgery service at Chang Gung Memorial Hospital under fellowship director Professor Fu Chan Wei, who is ranked among the top-10 most influential plastic surgeons in the world.
“The programme’s greatest value lies in its team-based approach, allowing healthcare professionals from diverse disciplines to undergo training together,” Dr Wong explained. “As a result of this training, the team now collaborates seamlessly, collectively advancing the field.”
For Dr Wong, the most memorable part of the HMDP programme was the mentors and friends he met during the fellowship. “The mentorship and teaching extended beyond clinical matters, and I’ve grown professionally to be a more wellrounded plastic surgeon. I’m grateful for the camaraderie and opportunity to share experiences with fellow colleagues,” he said.
Outside of work, Dr Wong volunteers his time as President of the Lymphoedema Society of Singapore, helping to raise awareness of lymphoedema among the public, advocating evidence-based care for lymphoedema, and empowering patients through advocacy.
Fishing is one of his favourite ways to relax. Being familiar with the tying of fishing knots is directly relevant to the field of surgery, as one must be adept and nimble with the surgical sutures, he said. It is also a hobby that he feels one can learn many life skills from, the most important being patience.
SKH Lymphoedema Service
To serve the needs of patients with diseases related to the lymphatic system, the SKH Lymphoedema Service was introduced in SKH in 2021 as a one-stop multidisciplinary service that prevents, treats and rehabilitates patients. Patients include those who have had cancer treatment such as surgery or radiotherapy.
The SKH team developed a novel technique, the Distallybased Lymphatic Microsurgical Healing Approach (dLYMPHA), to reduce the risk of lymphoedema in breast cancer patients undergoing treatment. A lymphatic bypass procedure in the upper limb is done at the same time as the breast cancer surgery to significantly reduce the likelihood of developing lymphoedema in the future.
Microsurgical reconstruction is a type of surgery that uses a microscope to help surgeons work on very small parts of the body, such as tiny blood vessels and nerves. It allows tissue to be moved from one place to another, ensuring the tissues stay alive by connecting their blood vessels, and helps restore function and appearance, improving patients’ lives after serious health issues. Some common medical applications are breast reconstruction after cancer treatment, limb reconstruction after traumatic accidents or severe diabetic infection, and restoration of the lymphatic system in lymphoedema.
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