Worldwide assessment of healthcare personnel dealing with lymphoedema

Schulze, Henrike; Nacke, Marisa; Gütenbrunner, Christoph; Hadamitzky, Catarina

doi:10.1186/s13561-018-0194-6

Cited by 52 publications

(45 citation statements)

References 51 publications

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“…Around 250 million patients worldwide suffer with lymphedema. 50 Lymphatic dysfunction can be due to a congenital structural abnormality or due to a secondary cause from radiation, surgery, or burn. 51 Lymphatic dysfunction causes serum proteins and water to leak into the interstitial space, leading to the formation of lymphatic fluid, which is taken to the blood steam through the lymph system.…”

Section: Lymphedemamentioning

confidence: 99%

Practical Management of Common Skin Injuries, Lacerations, Wounds, Trigger Fingers, and Burns

Akiki

Mehrzad

2020

J Am Board Fam Med

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Primary care clinicians encounter many conditions during their day-today visits with patients. A few of these common presentations include burns, lacerations, trauma to the hand, and wounds, some of which do not require an evaluation by a specialist and can be managed outpatient by primary care clinicians. In this article, we share evidence-based tips to avoid common pitfalls in primary care recognition and management of such presentations as well as guide them to manage many of these conditions themselves. We also provide guidance in the decision to refer the patient to a plastic surgeon or other specialists.

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Section: Lymphedemamentioning

confidence: 99%

Practical Management of Common Skin Injuries, Lacerations, Wounds, Trigger Fingers, and Burns

Akiki

Mehrzad

2020

J Am Board Fam Med

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“…Global prevalence estimates are as many as 250 million people worldwide. 14 The major single cause is lymphatic filariasis (LF), a parasitic disease affecting 17 million people in developing tropical countries where it is closely associated with poverty. 15 At the other end of the spectrum, breast-cancer-related lymphedema affects up to 40% of breast cancer survivors.…”

Section: Introductionmentioning

confidence: 99%

“…Despite being such a wideranging disease affecting people from every demographic and socioeconomic group, adequate provision of health care services is lacking in most countries. 14 Research to provide the evidence basis for better provision of such services is hampered by several issues, including heterogeneity in disease manifestation and difficulty in conducting large-scale, randomized interventions. 17 This is exacerbated by inconsistencies in diagnostic criteria and staging of disease progression.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Staging Systems to Assess Lymphedema Caused by Cancer Therapies, Lymphatic Filariasis, and Podoconiosis

Douglass

Kelly-Hope

2019

Lymphatic Research and Biology

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Background: Lymphedema is a disease of the skin and subcutaneous tissue resulting from a disturbance in lymph flow. Anyone can be affected, and causes include cancer therapy when lymph nodes are removed or irradiated, the parasitic disease lymphatic filariasis, and damage caused by exposure to irritant soils known as podoconiosis. Manifest lymphedema is progressive and a major contributor to disability, stigma, and social isolation for affected people. Although the pathogenesis of connective tissue changes in lymphedema will follow a similar course regardless of the disease of causation, several systems are used to stage progression. Disparity in these staging systems leads to inconsistency in reporting of the severity of lymphedema and prevents meta-analysis of research results. In the global health environment, integrated morbidity management for chronic illness is essential to meet the needs of affected people and to be sustainable for health care systems. Clinical descriptors for staging criteria within each system may assist clinicians in assessment and provide a format for consistency in reporting by lymphedema researchers. Methods and Results: Lymphedema staging systems used in oncology, filariasis, and podoconiosis settings were reviewed and the assessment techniques, diagnostic procedures, and clinical observations used by each system are described. The most commonly used staging systems are compared to identify similarities, and a matrix approach to lymphedema staging is proposed. Conclusion: A universal staging system would contribute to more consistent reporting of research on and clinical management of lymphedema arising from multiple causes.

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“…Lymphedema is a debilitating condition caused by insufficiency of the lymphatic system that affects over 250 million individuals worldwide 1 . It is characterized by progressive soft tissue swelling and can carry a significant disease burden 2 .…”

Section: Introductionmentioning

confidence: 99%

A Pre-clinical Animal Model of Secondary Head and Neck Lymphedema

Daneshgaran

Paik

et al. 2019

Sci Rep

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Head and neck lymphedema (HNL) is a disfiguring disease affecting over 90% of patients treated for head and neck cancer. Animal models of lymphedema are used to test pharmacologic and microsurgical therapies; however, no animal model for HNL is described in the literature to date. In this study we describe the first reproducible rat model for HNL. Animals were subjected to two surgical protocols: (1) lymphadenectomy plus irradiation; and (2) sham surgery and no irradiation. Head and neck expansion was measured on post-operative days 15, 30 and 60. Magnetic resonance imaging (MRI) was acquired at the same time points. Lymphatic drainage was measured at day 60 via indocyanine green (ICG) lymphography, after which animals were sacrificed for histological analysis. Postsurgical lymphedema was observed 100% of the time. Compared to sham-operated animals, lymphadenectomy animals experienced significantly more head and neck swelling at all timepoints (P < 0.01). Lymphadenectomy animals had significantly slower lymphatic drainage for 6 days post-ICG injection (P < 0.05). Histological analysis of lymphadenectomy animals revealed 83% greater subcutis thickness (P = 0.008), 22% greater collagen deposition (P = 0.001), 110% greater TGFβ1+ cell density (P = 0.04), 1.7-fold increase in TGFβ1 mRNA expression (P = 0.03), and 114% greater T-cell infiltration (P = 0.005) compared to sham-operated animals. In conclusion, animals subjected to complete lymph node dissection and irradiation developed changes consistent with human clinical postsurgical HNL. This was evidenced by significant increase in all head and neck measurements, slower lymphatic drainage, subcutaneous tissue expansion, increased fibrosis, and increased inflammation compared to sham-operated animals.

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Worldwide assessment of healthcare personnel dealing with lymphoedema

Cited by 52 publications

References 51 publications

Practical Management of Common Skin Injuries, Lacerations, Wounds, Trigger Fingers, and Burns

Practical Management of Common Skin Injuries, Lacerations, Wounds, Trigger Fingers, and Burns

Comparison of Staging Systems to Assess Lymphedema Caused by Cancer Therapies, Lymphatic Filariasis, and Podoconiosis

A Pre-clinical Animal Model of Secondary Head and Neck Lymphedema

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