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British Journal of Nursing (Mark Allen... Jun 2022Lymphoedema is associated with dysfunctional lymphatics, tissue fibrosis and inflammatory changes in the skin and local tissue. Ensuring compression supports tissue...
AIM
Lymphoedema is associated with dysfunctional lymphatics, tissue fibrosis and inflammatory changes in the skin and local tissue. Ensuring compression supports tissue health is crucial to managing lymphoedema. Providing patients with safe compression which enhances their tissue health is paramount when supporting their 24-hour self-management regimens. This case study explores the use of a new compression garment in two sitting positions in an adult with primary lymphoedema.
METHOD
An 18-year-old female (body mass index 25.2 kg/m) with Milroy's disease was recruited. She attended two separate 1-hour sessions to evaluate tissue oxygenation (StO) in chair-sitting and long-sitting (sitting up with a supported back and legs horizontal) positions. Following removal of her usual class 2 (20-30 mmHg) flat-knit compression hosiery, StO was recorded for 20 minutes: pre-, during and post the application of an adjustable compression garment (Lohmann & Rauscher) to the right leg.
RESULTS
In the long-sitting position, StO levels started high at baseline (94.5%), and were relatively maintained both during and post-a short 20-minute intervention (94.1%). In the chair-sitting position, StO levels were significantly lower at baseline (52%), showing a 77% increase during the intervention (92%), followed by a small 9% decrease post-intervention (83.7%).
CONCLUSION
This compression garment significantly increased StO levels in the chair-sitting position, while maintaining the effects of the patient's compression stockings, in the long-sitting position. Similar to non-lymphoedematous limbs, the patient's normal prescription hosiery maintains StO. Through implementation of the short intervention sessions, night compression garments may have the potential to improve tissue health in individuals with primary lymphoedema, encouraging self-management and offering a potential night compression solution where the need arises in a 24-hour management plan.
Topics: Adolescent; Adult; Clothing; Compression Bandages; Female; Humans; Leg; Lymphedema; Pressure; Stockings, Compression
PubMed: 35736853
DOI: 10.12968/bjon.2022.31.12.S34 -
Clinical & Experimental Metastasis Feb 2022This manuscript is a summary of findings focusing on various aspects of secondary lymphedema specifically as a sequelae of treatment for cancer. The topic was addressed... (Review)
Review
This manuscript is a summary of findings focusing on various aspects of secondary lymphedema specifically as a sequelae of treatment for cancer. The topic was addressed at a session held during the 8th International Congress on Cancer Metastasis that was unique a for the inclusion of patients with lymphedema and therapists joining physicians, healthcare professionals, and researchers in an effort to give an overview of secondary lymphedema following cancer therapy as well as highlighting the unknowns in the field. Lymphedema is defined and both diagnosis and incidence of cancer-related lymphedema are explored. Further, exploration of imaging options for lymphedema and information on the genetic research for patients with cancer-related secondary lymphedema are presented. Patient education and early detection methods are then explored followed by conservative treatment. Finally, an examination of surgical treatment methods available for patients with lymphedema is covered. Overall, this manuscript presents valuable information and updates for those not familiar with incidence, diagnosis, early detection, and rehabilitation of patients with cancer-related secondary lymphedema.
Topics: Humans; Lymphedema; Neoplasms
PubMed: 33950413
DOI: 10.1007/s10585-021-10096-w -
VASA. Zeitschrift Fur Gefasskrankheiten 2016Lymphoedema is a common and progressive disease which causes deterioration of the quality of life of patients. It is divided into two groups: primary and secondary... (Review)
Review
Lymphoedema is a common and progressive disease which causes deterioration of the quality of life of patients. It is divided into two groups: primary and secondary lymphoedema. Nowadays, the majority of patients with lymphoedema are associated with a malignancy or its treatment modalities, such as cancer surgery and radiation therapy. Accurate diagnosis and effective treatment are crucial for alleviating the symptoms, preventing progression and reducing the potential risks of lymphoedema. This report provides an overview of the management of lymphoedema.
Topics: Drainage; Exercise; Humans; Intermittent Pneumatic Compression Devices; Lymphedema; Skin Care; Stockings, Compression; Surgical Procedures, Operative
PubMed: 27428496
DOI: 10.1024/0301-1526/a000539 -
Clinics in Plastic Surgery Apr 1987Despite our improved knowledge of the lymphatic system, lymphedema remains an incurable disease. Its pathogenesis is still poorly understood, but fortunately the... (Review)
Review
Despite our improved knowledge of the lymphatic system, lymphedema remains an incurable disease. Its pathogenesis is still poorly understood, but fortunately the majority of patients can be satisfactorily managed by conservative means. Surgical intervention is offered only in cases of refractory disease and does not offer a surgical cure. At the present time, there are five major surgical options: lymphangioplasty, buried dermal flap, lymphaticovenous shunts, the Charles procedure, and the staged subcutaneous excision beneath flaps. Lymphangioplasty is usually limited to those patients with limited life expectancy, because the beneficial effects are transient. The most frequently used procedures--the buried dermal flap, the Charles procedure, and the subcutaneous excision beneath flaps--offer patients symptomatic improvement, primarily through the excision of lymphedematous subcutaneous tissue. Much controversy still exists as to the efficacy and future applicability of both the enteromesenteric bridge and microlymphatic surgery, which are currently under investigation. Long-term follow-up will be necessary. The discouraging fact remains that no procedure cures lymphedemia; however, we believe that, at this time, the subcutaneous excision beneath skin flaps offers the most reliable and consistently beneficial means of surgically managing the symptoms of lymphedema.
Topics: Humans; Lymphedema
PubMed: 3555946
DOI: No ID Found -
Nursing Standard (Royal College of...Lymphoedema is a symptom of a malfunctioning lymphatic system. It is characterised by chronic swelling caused by the accumulation of lymph. Rebecca Penzer examines the... (Review)
Review
Lymphoedema is a symptom of a malfunctioning lymphatic system. It is characterised by chronic swelling caused by the accumulation of lymph. Rebecca Penzer examines the nursing management of lymphoedema and the ways in which non-specialist nurses can offer support and promote self-care in patients with this potentially debilitating condition.
Topics: Developing Countries; Elephantiasis, Filarial; Humans; Lymphedema; Nursing Assessment; Skin Care
PubMed: 12772387
DOI: 10.7748/ns2003.05.17.35.45.c3392 -
The American Journal of Medicine Mar 2001Lymphedema is a set of pathologic conditions that are characterized by the regional accumulation of excessive amounts of interstitial protein-rich fluid. These occur as... (Review)
Review
Lymphedema is a set of pathologic conditions that are characterized by the regional accumulation of excessive amounts of interstitial protein-rich fluid. These occur as a result of an imbalance between the demand for lymphatic flow and the capacity of the lymphatic circulation. Lymphedema can result from either primary or acquired (secondary) disorders. In this review, the pathophysiology, classification, natural history, differential diagnosis, and treatment of lymphedema are discussed.
Topics: Humans; Lymphedema
PubMed: 11239847
DOI: 10.1016/s0002-9343(00)00727-0 -
Current Opinion in Immunology Aug 2018The lymphatic vasculature plays vital roles in immune surveillance, fluid homeostasis and fat absorption in the body. Lined by endothelial cells, the lymphatic system is... (Review)
Review
The lymphatic vasculature plays vital roles in immune surveillance, fluid homeostasis and fat absorption in the body. Lined by endothelial cells, the lymphatic system is functionally distinct from the blood vasculature, and fulfills different physiological functions. In recent years, insight from zebrafish, mice and human patients have improved our understanding of lymphatics, and the interplay between zebrafish genetics, studies in mice and GWAS analysis in human patients have identified genes that, when mutated, will lead to lymphedema formation. Here, we focus on components of the Vegfr3 pathway, and how they are connected to Milroy disease and Hennekam syndrome.
Topics: Animals; Embryo, Nonmammalian; Fishes; Genome-Wide Association Study; Homeostasis; Humans; Immunologic Surveillance; Lipid Metabolism; Lymphangiogenesis; Lymphatic Vessels; Lymphedema; Mice; Signal Transduction; Vascular Endothelial Growth Factor Receptor-3
PubMed: 29800868
DOI: 10.1016/j.coi.2018.05.003 -
Maternidade E Infancia; Arquivos... 1965
Topics: Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Lymphedema
PubMed: 14326734
DOI: No ID Found -
Genes Oct 2021This study explored mutations in the Fms-related tyrosine kinase 4/vascular endothelial growth factor receptor 3 gene () and lymphatic defects in patients with Milroy...
This study explored mutations in the Fms-related tyrosine kinase 4/vascular endothelial growth factor receptor 3 gene () and lymphatic defects in patients with Milroy disease (MD). Twenty-nine patients with lower limb lymphedema were enrolled. Sixteen patients had a familial history of MD, while 13 patients exhibited sporadic MD. Clinical signs, mutations, indocyanine green (ICG) lymphography findings, and skin tissue immunohistochemical staining results were evaluated. Twenty-eight variants in were identified. Twelve of these have previously been reported, while 16 are novel. Of the 28 variants, 26 are missense mutations, and the remaining two comprise a splicing mutation and a non-frame shift mutation. Twenty-five variants are located in the intracellular protein tyrosine kinase domain; three are located in the extracellular immunoglobulin domain. Substantially delayed contrast-enhanced tortuous lymphatic vessels were visualized to the ankle or knee level in 15 of 23 patients who underwent ICG lymphography. No initial lymphatic vessels were visualized in skin specimens from four patients who did not exhibit lymphatic vessels during imaging analyses. No specific variant was identified in relation to the unique clinical phenotype. Segmental dysfunction of lymphatic vessels and initial lymphatic aplasia are present in MD patients with mutations.
Topics: Adolescent; Adult; Ankle; Child; Child, Preschool; Female; Genetic Predisposition to Disease; Humans; Infant; Knee; Lower Extremity; Lymphedema; Lymphography; Male; Mutation, Missense; Protein Isoforms; Vascular Endothelial Growth Factor Receptor-3
PubMed: 34681005
DOI: 10.3390/genes12101611 -
Seminars in Pediatric Surgery Oct 2020Lymphedema is the chronic, progressive swelling of tissue due to inadequate lymphatic function. Over time, protein-rich fluid accumulates in the tissue causing it to... (Review)
Review
Lymphedema is the chronic, progressive swelling of tissue due to inadequate lymphatic function. Over time, protein-rich fluid accumulates in the tissue causing it to enlarge. Lymphedema is a specific disease and should not be used as a generic term for an enlarged extremity. The diagnosis is made by history and physical examination, and confirmed with lymphoscintigraphy. Intervention includes patient education, compression, and rarely, surgery. Patients are advised to exercise, maintain a normal body mass index, and moisturize / protect the diseased limb from incidental trauma. Conservative management consists of compression regimens. Operative interventions either attempt to address the underlying lymphatic anomaly or the excess tissue. Lymphatic-venous anastomosis and lymph node transfer attempt to create new lymphatic connections to improve lymph flow. Suction-assisted lipectomy and cutaneous excision reduce the size of the area by removing fibroadipose hypertrophy.
Topics: Child; Humans; Lymphedema
PubMed: 33069289
DOI: 10.1016/j.sempedsurg.2020.150972