Abstracts LympForsch, 2/2016
(full text in German)
Dermatolipectomy to remove fat deposits in the proximal thigh and male mons pubis
U. Wollina, B. Heinig, A. Nowak. LymphForsch 20 (2) 2016;60-64
Different pathologies of the subcutaneous fascia can lead to excess fat deposits in the proximal thigh and male mons pubis, causing both functional and aesthetic disturbances. The treatment of choice is dermatolipectomy. We report on the combined use of proximal thigh lift and puboplasty.
Keywords: subcutaneous fascia, obesity, male mons pubis, dermatolipectomy, puboplasty, proximal thigh lift
Using thickening of the retromalleolar region and swelling of the dorsum of the foot and Stemmer’s sign to diagnose lymphedema
W. J. Brauer, V. S. Brauer. LymphForsch 20 (2) 2016;65-70
Purpose: This study aimed to evaluate the sensitivity and specificity of Stemmer’s sign compared to the sensitivity and specificity of measurements of the thickening of the retromalleolar region and swelling of the dorsum of the foot when diagnosing lymphedema.
Material and methods: The study analyzed data of 659 legs from 333 patients that were examined to diagnose lymphedema or, in patients with confirmed lymphedema, to quantify lymph transport. Both clinical examination and a lymphoscintigraphic function test were used. The sensitivity and specificity of the two aforementioned bases for diagnosing lymphedema were calculated.
Results: When diagnosing lymphedema, thickening of the retromalleolar region and/or the swelling of the dorsum of the foot are more sensitive. If the positive Stemmer’s sign is weak, it is more specific than sensitive. If the thickening of the retromalleolar area and/or the swelling of the dorsum of the foot are distinct, they are similarly specific, but more sensitive than a distinct positive Stemmer’s sign.
Conclusion: We recommend including measurements of the thickening of the retromalleolar area and the swelling of the dorsum of the foot along with Stemmer’s sign in the clinical diagnosis of lymphedema.
Keywords: lymphedema, retromalleolar layer, profile of the arch of foot, Stemmer‘s sign, lymphoscintigraphic function test.
Lipedema and lipo-lymphedema – a matter of lifestyle? Results of the first Germany-wide online survey on the quality of life of affected women – Part 2: Liposuction, burden in daily activities and on the job, impact on health-related quality of life (HRQOL)
N. Schubert, H. Viethen. LymphForsch 20 (2) 2016;71-79
This section of the survey deals with women‘s personal perception of their body, mental and emotional stress, as well as restrictions posed by lipedema at work, in family life and in social settings. Lipedema has a significant impact on the health-related quality of life and the self-image of the affected women in all areas of life. 12.9 % (n=57) of the surveyed women state a full or partial social withdrawal, and 17.6 % (n=89) reported current or past suicidal tendencies due to the condition. Another 30.1 % (n=150) described their lives as not worth living. The survey provides evidence of the strong influence of lipedema and lipo-lymphedema on HRQOL.
Keywords: lipedema, lipohyperplasia dolorosa, liposuction, health-related quality of life, mental well-being
Digital documentation of patient data in lymphedema treatment: High quality, straightforward and free
K. Schiller. LymphForsch 20 (2) 2016;80-81
Physical therapists are contractually required to document patient data. Documentation enhances communication among colleagues, patients and physicians, and provides validation for the therapist. When documentation is performed digitally, time and money can be saved. However, any type of documentation has to comply with medical confidentiality, privacy protection and data-processing requirements.
Keywords: Documentation, digital, data protection.
Out-patient lymphedema management today and in the future: Teamwork among all medical disciplines and scientific associations
O. Gültig, S. Hemm. LymphForsch 20 (2) 2016;82-84
The past 20 years have seen considerable advancement in the implementation of outpatient lymphedema management among all the professionals in the lymphedema care chain. The reference book Lymphology Handbook (Leitfaden Lymphologie), which appeared recently, is the first of its kind to show every disease presentation in the context of a joint working process enlisting all the medical professions. New training courses, the growing cooperation among the scientific associations, the new S2k guidelines for the treatment of lymphedema, a patient self-help organization, opportunities for curricular training for medical practitioners, and numerous lymphology conferences and congresses have significantly increased the popularity of this specialized area. In contrast to these positive developments, the remuneration for physical therapy in this specialized area is completely inadequate. Medical practitioners with advanced lymphedema training do not receive appropriate payment for the time-consuming care and treatment of patients. Orientation towards the new lymphedema guidelines and increased debate concerning the health policy rules and standards in Germany and elsewhere are vital for the future.