Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review
Alessandro de Sire,
Luigi Losco,
Lorenzo Lippi,
Davide Spadoni,
Juste Kaciulyte,
Gokhan Sert,
Paola Ciamarra,
Marco Marcasciano,
Roberto Cuomo,
Alberto Bolletta,
Marco Invernizzi,
Emanuele Cigna
Affiliations
Alessandro de Sire
Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
Luigi Losco
Plastic Surgery and Microsurgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56122 Pisa, Italy
Lorenzo Lippi
Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy
Davide Spadoni
Department of Plastic and Reconstructive Surgery, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
Juste Kaciulyte
Department of Plastic and Reconstructive Surgery, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
Gokhan Sert
Department of Plastic and Reconstructive Surgery, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
Paola Ciamarra
Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Marco Marcasciano
Plastic and Reconstructive Surgery Unit, Department of Experimental and Clinical Medicine, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
Roberto Cuomo
Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
Alberto Bolletta
Plastic Surgery and Microsurgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56122 Pisa, Italy
Marco Invernizzi
Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy
Emanuele Cigna
Plastic Surgery and Microsurgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56122 Pisa, Italy
Lymphedema is a chronic disabling condition affecting a growing number of patients worldwide. Although lymphedema is not life-threatening, several reports underlined detrimental consequences in terms of distress, pain, functional impairment, and infections with a relevant decrease in quality of life. Currently, there is no cure, and the therapeutic management of this condition aims at slowing down the disease progression and preventing secondary complications. Early diagnosis is paramount to enhance the effects of rehabilitation or surgical treatments. On the other hand, a multidisciplinary treatment should be truly integrated, the combination of microsurgical and reductive procedures should be considered a valid strategy to manage extremity lymphedema, and rehabilitation should be considered the cornerstone of the multidisciplinary treatment not only for patients not suitable for surgical interventions but also before and after surgical procedures. Therefore, a specialized management of Plastic Reconstructive Surgeons and Physical and Rehabilitative Medicine physicians should be mandatory to address patients’ needs and optimize the treatment of this disabling and detrimental condition. Therefore, the aim of this review was to characterize the comprehensive management of lymphedema, providing a broad overview of the potential therapy available in the current literature to optimize the comprehensive management of lymphedema and minimize complications.
