• Archives of Plastic Surgery
• /
• 제48권6호
• /
• pp.670-677
• /
• 2021

An estimated 250 million people worldwide suffer from lymphedema. In the past, the first-line option for treatment was nonsurgical management, either in the form of compression garments or wrapping, or comprehensive decongestive therapy, with debulking surgery reserved for the more advanced cases. However, with improvements in microsurgical techniques and imaging modalities, surgical intervention is increasingly being utilized. This review highlights recent advancements in the surgical treatment of lymphedema, specifically focusing on improvements in imaging, surgical techniques, and prevention of lymphedema.

• CELLMED
• /
• 제13권16호
• /
• pp.62.1-62.4
• /
• 2023

Objective: Lymphedema case study through the application of Ortho-Cellular Nutrition Therapy (OCNT) Method: OCNT is implemented to a Korean female patient in her 70s with difficulties in walking due to severe swelling in one of her legs. Results: Lymphedema was improved following implementation of OCNT. Conclusion: Application of OCNT to lymphedema patient can be helpful.

• Archives of Plastic Surgery
• /
• 제50권6호
• /
• pp.635-636
• /
• 2023

• Archives of Plastic Surgery
• /
• 제50권4호
• /
• pp.422-431
• /
• 2023

Background Posttraumatic lymphedema (PTL) is sparsely described in the literature. The aim of this study is to propose a comprehensive approach for prevention and treatment of PTL using lymphovenous anastomosis (LVA) and lymphatic vessels free flap, reporting our experience in the management of early-stage lymphedema. Methods A retrospective observational study was performed between October 2017 and July 2022. Functional assessment with magnetic resonance lymphangiography and indocyanine green lymphography was performed. Patients with lymphedema and functional lymphatic channels were included. Cases with limited soft tissue damage were proposed for LVA, and those with acute or prior soft tissue damage needing skin reconstruction were proposed for superficial circumflex iliac artery perforator lymphatic vessels free flap (SCIP-LV) to treat or prevent lymphedema. Primary and secondary outcomes were limb volume reduction and quality of life (QoL) improvement, respectively. Follow-up was at least 1 year. Results Twenty-eight patients were operated using this approach during the study period. LVA were performed in 12 patients; mean reduction of excess volume (REV) was 58.82% and the improvement in QoL was 49.25%. SCIP-LV was performed in seven patients with no flap failure; mean REV was 58.77% and the improvement QoL was 50.9%. Nine patients with acute injury in lymphatic critical areas were reconstructed with SCIP-LV as a preventive approach and no lymphedema was detected. Conclusion Our comprehensive approach provides an organized way to treat patients with PTL, or at risk of developing it, to have satisfactory results and improve their QoL.

• Archives of Plastic Surgery
• /
• 제33권3호
• /
• pp.294-297
• /
• 2006

Lymphedema is one of the most common complications of mastectomy. It decreases quality of life and causes functional or aesthetical problems in post-mastectomy patients. Axillary lymph needs dissection (ALND), and radiation therapy(RTx) is known as the representative factor of lymphedema. Authors discovered that breast reconstructions using latissimus dorsi(LD) myocutaneous flap decrease the incidence of lymphedema in spite of these risk factors. Therefore we compared the incidence of lymphedema between the patients who underwent breast reconstructoins by LD pedicled flap, and the patients who did not undergo breast reconstructions from January 2002 to December 2004. Lymphedema was diagnosed when difference of arm circumference was over 2cm or limitation of joint movement was greater than 20 degrees. Overall incidence of lymphedema was 14.0%, and it was 18.9% in case of ALND, and 21.1% in case of RTx, respectively. But the incidence of breast-reconstructed patients using LD pedicled flap was 3.3%. This result reveals that LD pedicled flap decreases incidence of lymphedema significantly. In the future, it is recommended to identify the causes of decrease in the incidence of lymphedema in case of breast reconstructed by LD myocutaneous pedicled flap, for example lymphoscintigraphy and so on.

• Journal of Hospice and Palliative Care
• /
• 제4권2호
• /
• pp.161-164
• /
• 2001

Elephantiasis, which is the final stage of lymphedema, has swelling, papillomas and discharges in the skin. Although this disease is recorded in literature since 50 AD, the treatment is not yet. After all this time, complex lymphedema therapy (CLT) involving lymphatic massaging, bandaging, exercise, and skin care is becoming recognized as the best approach to care for people who develop lymphedema. The patient was a 30-year-old male who complained of swelling, papillomas, and discharges on left leg. He was received with CLT for 2 months, and the symptoms of him were improved.

• Journal of Biomedical Engineering Research
• /
• 제34권4호
• /
• pp.170-176
• /
• 2013

Lymphedema is a phenomenon in which fluid is accumulated inside tissues due to the damaged lymphatic systems. Lymphedema can cause complications such as lymphangitis, infection, changes in skin texture, fibrosis, and lymphangiosarcoma. In this study, a lymphedema screening system based on the elasticity of the skin is proposed to easily quantify lymphedema. The developed probe consists of touch sensors, a load cell and hall-effect sensors to measure the indentation force on the skin and the return time of the skin. The developed system can be used to estimate the change in the elasticity of the skin to quantify lymphedema. The system was tested with a thyroid phantom and gelatin phantoms of different concentrations and the resulting force and the time were recorded. It was found that the increase in the elasticity leads to a higher indentation force and shorter return time. This shows that the developed system can monitor the change in the skin elasticity by measuring the return time and the indentation force. The feasibility of the system in clinical applications will be evaluated in the future study.

• Current Optics and Photonics
• /
• 제1권2호
• /
• pp.132-137
• /
• 2017

To investigate the usefulness of optical coherence tomography (OCT) for imaging lymphedema, we directly compared it to other histological methods in a mouse model of lymphedema. We performed detailed imaging of the lymphedema lesion on a mouse tail. We imaged the mouse tail in vivo with OCT and created histopathological samples. We constructed a spectrometer-based OCT system using a fiber-optic Michelson interferometer. The light was directed to 50:50 couplers that split the light into reference and sample arms. Backscattered light from a reference mirror and the sample produced an interference fringe. An OCT image of the lymphedema model revealed an inflammatory reaction of the skin that was accompanied by edema, leading to an increase in the light attenuation in the dermal and subcutaneous layers. Similar to OCT image findings, histological biopsy showed an inflammatory response that involved edema, increased neutrophils in epidermis and subdermis, and lymphatic microvascular dilatation. Furthermore, the lymphedema model showed an increase in thickness of the dermis in both diagnostic studies. In the mouse tail model of lymphedema, OCT imaging showed very similar results to other histological examinations. OCT provides a quick and useful diagnostic imaging technique for lymphedema and is a valuable addition or complement to other noninvasive imaging tools.

• Archives of Plastic Surgery
• /
• 제48권2호
• /
• pp.219-223
• /
• 2021

Background A micro-arteriovenous fistula (AVF) is a minute, short shunt between an artery and a vein that does not pass through a capillary. We investigated the association between micro-AVFs and lymphedema using computed tomography angiography (CTA) and venous blood gas analysis. Methods In 95 patients with lower limb lymphedema, the presence or absence of early venous return (EVR) was compared between patients with primary and secondary lymphedema. Furthermore, we investigated the difference in the timing of edema onset in patients with secondary lymphedema with or without EVR using CTA. In 20 patients with lower limb lymphedema with confirmed early EVR in a unilateral lower limb, the partial pressure of oxygen (PO₂) was compared between the lower limb with EVR and the contralateral lower limb. Results Secondary lymphedema with or without EVR occurred at an average of 36.0±59.3 months and 93.5±136.1 months, respectively; however, no significant difference was noted. PO₂ was 57.6±11.7 mmHg and 44.1±16.4 mmHg in the EVR and non-EVR limbs, respectively, which was a significant difference (P=0.005). Conclusions EVR and venous blood gas analysis suggested the presence of micro-AVFs in patients with lower extremity edema. Further research is warranted to examine the cause of micro-AVFs, to advance technology to facilitate the confirmation of micro-AVFs by angiography, and to improve lymphedema by ligation of micro-AVFs.

• The Journal of Korean Physical Therapy
• /
• 제27권5호
• /
• pp.339-344
• /
• 2015

Purpose: The purpose of this study was to determine the effects of high and low resistance exercise using an elastic band on the strength and lymphedema of upper extremity in patients with breast cancer. Methods: Seventeen female patients with breast cancer related lymphedema were randomly allocated to the high (n=9) or low (n=8) resistance exercise group. Both groups participated in the elastic band exercise program three times a week for eight weeks. For the high resistance exercise group (HR), the resistance was gradually increased, while maintaining constant intensity of exercise for the low resistance exercise group (LR). Assessments made include the upper extremity muscle strength and lymphedema before and after training. Results: After the exercise program, the HR showed significantly improved shoulder flexion and elbow flexion strength variation compared to the LR (p<0.05). Upper arm edema rate was significantly decreased in HR (p<0.05), but the difference between the two groups was not significant. Conclusion: These findings suggest that the elastic band exercise helps improve the strength and lymphedema of upper extremity in patients with breast cancer. In particular, high resistance exercise is more effective in improving muscle strength and does not exacerbate lymphedema, rather may improve upper arm edema if it is applied with a low elastic bandage or compression sleeve.