Lymphedema: New Concepts in Diagnosis and Treatment
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Purpose of Review
This review’s aim is to coalesce current evidence regarding the lymphatic system and lymphedema, bridge the gap from traditional approaches to emerging concepts, and present simple strategies that can be immediately implemented into everyday clinical practice.
New evidence of the microcirculation redefines all edema as lymphedema and having the potential to result in chronic inflammation and deleterious soft tissue changes. These soft tissue changes are easily identifiable through simple manual tests that also help direct interventions. CDT is the gold standard of treatment, but components are evolving with the emergence of new technologies and new understandings of mechanobiology. The lymphatic and integumentary systems are interdependent, requiring concurrent lymphedema and wound management strategies.
Optimization of the lymphatic system is key to edema management and wound healing. Future research is needed to progress individualized diagnostics of lymphatic vasculature so treatment interventions can be customized to each patient.
KeywordsLymphedema Complete decongestive therapy Lymphedema continuum Lymphatic and integumentary rehabilitation Manual lymphatic drainage Lymphedema and wound healing
Compliance with Ethical Standards
Conflict of Interest
Robyn Bjork is Founder, President, and Executive Director of Education for the International Lymphedema and Wound Training Institute (ILWTI). She was also a medical consultant and previous Director of Medical Education and Innovation for Sigvaris, Inc.
Dr. Heather Hettrick is faculty and Director of Wound Education for ILWTI.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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