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Conservative management of lymphoedema in children: a systematic review
J Jane Phillips1, Susan J Gordon1
1School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia.
Insights
Conservative management of pediatric lymphoedema has limited evidence. Pneumatic compression shows potential, but further research is needed for optimal use and other interventions.
Area of Science:
- Pediatric Medicine
- Clinical Research
- Evidence-Based Practice
Background:
- Pediatric lymphoedema management lacks standardized best practices.
- Conservative approaches are crucial for long-term patient outcomes.
Purpose of the Study:
- To systematically review the literature for best practices in conservative pediatric lymphoedema management.
- To identify current evidence supporting various conservative treatment modalities.
Main Methods:
- Systematic literature review following the PRISMA protocol.
- Searched Ovid Medline, Cinahl, and Scopus for pediatric lymphoedema management studies.
- Included studies focused on conservative treatment in children; excluded specific conditions and adult populations.
Main Results:
- Eight studies met inclusion criteria (4 case reports, 2 retrospective, 2 prospective).
- Studies were of low quality, exhibiting poor methodology, small sample sizes, and inconsistent outcomes.
- Limited evidence supports pneumatic compression for pediatric lymphoedema.
Conclusions:
- Current evidence for conservative pediatric lymphoedema management is low-level.
- Further research is essential to optimize pneumatic compression parameters.
- Investigating additional conservative interventions is recommended.
Purpose:
A systematic literature review was conducted to determine best practice conservative management of pediatric lymphoedema.
Method:
The PRISMA protocol was followed; a search of Ovid Medline, Cinahl and Scopus was conducted using the search terms children OR pediatric OR adolescent AND lymphoedema OR lymphedema. Studies about management or treatment of lymphoedema in children were included while studies about filariasis, imaging, pathology, secondary lymphoedema, surgical techniques, central lymphoedema and those with participants with a median age greater than 18 years were excluded.
Results:
Of 738 possible studies identified, eight studies were eligible for inclusion in the review: four case reports, two retrospective service reviews and two prospective studies investigating different interventions. All studies were rated using the NHMRC hierarchy of evidence and appraised by both authors using the McMaster University Critical Review Form. Studies were of low quality with poor descriptions of management, small sample size, unclear and inconsistent methodology and irreproducible outcome measures.
Conclusion:
This review identified low level evidence to support the use of pneumatic compression in the management of pediatric lymphoedema. Further research is required to identify optimal parameters for application of pneumatic compression and to investigate the use of other interventions for conservative management of pediatric lymphoedema.
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