Answer:
The approaches to the surgical treatment of lymphedema fall into two categories. Either, one attempts to ablate the offending tissue, leaving behind only those tissues drained by the competent lymphatic system. Alternatively, attempts are made to augment lymph flow or egress from the lymphadematous extremity by 1) attempting to establish communication between the superficial, compromised lymphatics, and the deep, competent system; 2) the provision of an alternative route of lymph drainage (external); 3) the construction of direct lymphatic to venous anastomoses.
One of the earliest procedures is the Kondolean procedure (1912). It involves resection of subcutaneous lymphedematous tissue as well as creating a fascial window as a means of establishing communication between the superficial and deep lymphatics. Apparently, the fascial window does not work, and only the tissue resection part of this procedure is still used, and erroneously referred to as the Kondolean procedure.
The Charles procedure (1912) is an ablative procedure whereby the affected subcutaneous tissue is resected down to muscle fascia and the area covered with skin grafts taken from the resected specimen. This procedure is no longer performed. The Charles procedure, as an eponym for the surgical treatment of leg edema, is actually a longstanding misnomer, seeing as Sir Richard Henry Havelock Charles is known for describing a treatment for scrotal lymphedema in 1901, having treated a series of 140 patients with this condition. Sir Havelock had never treated a patient with leg edema, but in 1950, Sir Archibald McIndoe, an eminent British plastic surgeon wrote an article in which he mistakenly claimed that Sir Charles had treated a patient with leg edema with excision of subcutaneous tissue and skin grafts back in 1912. Since then, the error has been propagated throughout the years.