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Do surgical interventions for limb lymphoedema reduce cellulitis attack frequency?

Identifieur interne : 000378 ( PubMed/Checkpoint ); précédent : 000377; suivant : 000379

Do surgical interventions for limb lymphoedema reduce cellulitis attack frequency?

Auteurs : Amy R. Sharkey ; Samuel W. King ; Alexander J. Ramsden ; Dominic Furniss

Source :

RBID : pubmed:27661464

Abstract

Recurrent cellulitis is a frequent and challenging complication of lymphoedema. British Lymphology Society cellulitis guidelines state that decongestive lymphatic therapy reduces the frequency of cellulitis attacks, but do not mention the effect of surgical interventions. This systematic review aims to assess whether surgical interventions for lymphoedema reduce the frequency of attacks of cellulitis.

DOI: 10.1002/micr.30115
PubMed: 27661464


Affiliations:


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pubmed:27661464

Le document en format XML

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<nlm:affiliation>Department of Plastic and Reconstructive Surgery, Nuffield Orthopaedic Centre, Oxford, OX3 7HE.</nlm:affiliation>
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<title level="j">Microsurgery</title>
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<div type="abstract" xml:lang="en">Recurrent cellulitis is a frequent and challenging complication of lymphoedema. British Lymphology Society cellulitis guidelines state that decongestive lymphatic therapy reduces the frequency of cellulitis attacks, but do not mention the effect of surgical interventions. This systematic review aims to assess whether surgical interventions for lymphoedema reduce the frequency of attacks of cellulitis.</div>
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<Year>2016</Year>
<Month>09</Month>
<Day>23</Day>
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<DateRevised>
<Year>2017</Year>
<Month>05</Month>
<Day>25</Day>
</DateRevised>
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<ISSN IssnType="Electronic">1098-2752</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>37</Volume>
<Issue>4</Issue>
<PubDate>
<Year>2017</Year>
<Month>May</Month>
</PubDate>
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<Title>Microsurgery</Title>
<ISOAbbreviation>Microsurgery</ISOAbbreviation>
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<ArticleTitle>Do surgical interventions for limb lymphoedema reduce cellulitis attack frequency?</ArticleTitle>
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<MedlinePgn>348-353</MedlinePgn>
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<AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Recurrent cellulitis is a frequent and challenging complication of lymphoedema. British Lymphology Society cellulitis guidelines state that decongestive lymphatic therapy reduces the frequency of cellulitis attacks, but do not mention the effect of surgical interventions. This systematic review aims to assess whether surgical interventions for lymphoedema reduce the frequency of attacks of cellulitis.</AbstractText>
<AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">Embase, Medline, and the Cochrane database were searched for relevant articles from database inception to January 2016. Four hundred and thirty-six abstracts were retrieved. Studies were included which contained quantitative data on cellulitis incidence before and after a surgical intervention. Two independent reviewers applied selection criteria, selecting 27 papers for full text review. Two were unavailable in the UK from any source.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">A variety of surgical techniques were utilized in the 25 papers included: lymphaticovenous anastomosis, superficial-to-deep lymphaticolymphatic anastomosis, lymph node transfer, Charles procedure, muscle flap transfer, Homan's procedure, and subcutaneous tissue excision below skin flaps. Five studies combined techniques. One study compared the intervention to a control group (physical therapy). Cellulitis incidence was decreased following surgical intervention in 24/25 studies included. Eight had quantifiable reductions in cellulitis over a set follow-up period; in the other 16 preoperative incidence was not precisely defined.</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Surgery appears effective at reducing cellulitis incidence in lymphoedema. However, high quality evidence from randomized controlled trials is lacking. Future research should concentrate on comparison with control groups, for example compression alone versus compression with surgical intervention, in patients with lymphoedema and greater than two attacks of cellulitis per year.</AbstractText>
<CopyrightInformation>© 2016 Wiley Periodicals, Inc.</CopyrightInformation>
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<Affiliation>Oxford University Medical School, John Radcliffe Hospital, Medical Sciences Divison, Oxford University, Oxford, Oxfordshire, OX3 9DU.</Affiliation>
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<Affiliation>Department of Plastic and Reconstructive Surgery, Nuffield Orthopaedic Centre, Oxford, OX3 7HE.</Affiliation>
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<Affiliation>Oxford Lymphoedema Practice, Department of Plastic Surgery, The Manor Hospital, Beech Road, Oxford, OX3 7RP.</Affiliation>
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<Affiliation>Oxford Lymphoedema Practice, Department of Plastic Surgery, The Manor Hospital, Beech Road, Oxford, OX3 7RP.</Affiliation>
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<Affiliation>Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Oxford University, OX3 7HE.</Affiliation>
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<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="N">cellulitis</Keyword>
<Keyword MajorTopicYN="N">lymphaticovenous anastomosis</Keyword>
<Keyword MajorTopicYN="N">lymphedema lymphoedema</Keyword>
<Keyword MajorTopicYN="N">microsurgery</Keyword>
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