Regular Compression Therapy May Not Be Necessary for Lymphedema in Arms without a Subcutaneous Echo-Free Space

Ann Vasc Surg. 2020 Jan:62:258-262. doi: 10.1016/j.avsg.2019.04.020. Epub 2019 Sep 5.

Abstract

Background: To study the effect of prolonged complex decongestive therapy (CDT) on lymphedema in arms without a subcutaneous echo-free space (SEFS) on subcutaneous tissue ultrasonography.

Methods: Fifty-one patients with arm lymphedema treated for longer than 1 year using CDT in our clinic were retrospectively evaluated. Before starting CDT, subcutaneous tissue ultrasonography was performed to examine for the presence of an SEFS. Two-stage CDT was performed as recommended by the International Society of Lymphology. Limb circumference was measured, and limb volume was calculated at the initial and latest visits.

Results: In patients with lymphedema in which SEFS was observed anywhere in the arm on the initial visit (n = 25), the edema ratio was significantly reduced by a median of -15% (range, -106% to 17%; P < 0.001). On the other hand, in the arms with lymphedema in which SEFS was not observed (SEFS[-], n = 26), the edema ratio was not changed significantly by CDT (median, 1% [range, -30% to 23%]). In arms without an SEFS that were not treated using arm sleeves regularly (n = 15), no increase in edema ratio was observed (median, 1% [range, -29% to 16%]).

Conclusions: In arms with lymphedema without SEFS, the effect of CDT on the reduction of arm volume is limited.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arm / diagnostic imaging*
  • Arm / physiopathology
  • Compression Bandages*
  • Female
  • Humans
  • Lymphedema / diagnostic imaging
  • Lymphedema / physiopathology
  • Lymphedema / therapy*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pressure
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Ultrasonography