Use of thermotherapy in management of lymphedema: clinical observations

Abstract

We report clinical observations in 67 patients with chronic lymphedema undergoing hyperthermia. Our technique of hyperthermia is an alternative to microwave therapy, particularly where lymphangitis coexists in the same limb. Preoperative diagnostic evaluation including lymphatic and venous isotopic scintigraphy, Doppler venous flow metrics, and pressure manometry play an essential role in delineating the status of both the lymphatic and venous systems and in determining if hyperthermia is indicated. Our method of treatment consists of producing hot and humid ambience inside the chamber where the limb is situated. The data demonstrate the feasibility of our method of hyperthermia in 67 patients with postlymphangitis lymphedema (either arm or leg). Using this technique, improvement was seen in both limb function and edema.

The effectiveness and safety of heat/cold therapy in adults with lymphoedema: systematic review

“…After title and abstract screening, 78 full papers were retrieved, of which 18 studies were included (19 citations). Of these 19 included studies, 11 studies used a before-and-after design [ 18 , 19 , 29–37 ], four used a controlled before-and-after study design [ 38–41 ], three were randomised controlled trials (RCTs) [ 41–43 ], and one study used a cross-over randomized study design [ 44 ]. They were published between 1986 and 2022 [ 37 , 43 ].…”

“…They were published between 1986 and 2022 [ 37 , 43 ]. These studies took place in various countries, of which seven were from China [ 30 , 32 , 34 , 36 , 37 , 40 , 41 ], four from Italy [ 19 , 29 , 31 , 38 ], three studies from Japan [ 35 , 42 , 45 ], two studies from India [ 18 , 39 ], and one study each from Brazil, Egypt, and USA [ 33 , 43 , 44 ].…”

“…Across the 18 included studies, a total of 1137 people with lymphoedema were included (see Table 1 for study characteristics). The majority of studies included adults with secondary lymphoedema of the legs [ 35 , 36 , 40 , 41 , 45 ], arms [ 32 , 33 , 38 , 43 ], or both arms and legs [ 19 , 29 , 30 ]. Included studies took place in a range of clinical environments of which nine were within a hospital [ 32 , 34–37 , 39–42 ], six in outpatients [ 30 , 31 , 33 , 38 , 43 , 45 ], three in a lab [ 19 , 29 , 44 ], and one at home [ 18 ].…”

“…The remaining 17 studies used localised heat therapy provided through 20 modalities, of which five studies used microwave therapy [ 32 , 34 , 37 , 40 , 41 ]; four studies used microwave plus bandaging [ 30 , 42 ]; with two including vibration [ 40 , 45 ]; three studies used hot water [ 19 , 29 , 40 ]; two studies used light therapy [ 18 , 39 ]; one study used light therapy plus interferential therapy [ 39 ]; light therapy plus interferential therapy plus compression [ 39 ]; infrared [ 36 ]; electric blanket plus mechanical lymph drainage [ 44 ]; ultrasound [ 38 ] and electromagnetic therapy [ 31 ]. The majority of these studies that reported skin temperature set a target tissue temperature of between 39 and 42 °C [ 19 , 29 , 31 , 34 , 36 , 37 ] and the majority of studies which reported total intervention treatment time provided treatments between 1200 up to 3600 min of treatment [ 19 , 34–36 , 40–42 ].…”

Examination of the effects of a new compression garment on skin tissue oxygenation in healthy volunteers

“…28 Literature has suggested that increased skin temperature increases lymph flow rate and protein concentration, 29 however while thermotherapy has been suggested as an alternative management tool for lymphoedema, conflicting evidence exists around its true impact on lymph drainage. [30][31][32][33][34] This study aimed to explore the effects of a new compression garment (Tributewrap TM ) on tissue oxygenation and temperature in three different sitting positions in healthy adults. Due to the padded/quilted structure of this compression garment it is important to understand whether the chevron quilted structure of this compression garment leads to an increase in tissue oxygenation through its design, or through thermal therapy and a temperature increase.…”