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Do surgical interventions for limb lymphoedema reduce cellulitis attack frequency?

Amy R Sharkey1, Samuel W King1, Alexander J Ramsden2,3

  • 1Oxford University Medical School, John Radcliffe Hospital, Medical Sciences Divison, Oxford University, Oxford, Oxfordshire, OX3 9DU.

Microsurgery
|September 24, 2016
PubMed
Summary
This summary is machine-generated.

Surgical interventions for lymphoedema significantly reduce recurrent cellulitis attacks. While effective, high-quality evidence from randomized controlled trials is needed to confirm these findings for cellulitis treatment.

Keywords:
cellulitislymphaticovenous anastomosislymphedema lymphoedemamicrosurgery

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Area of Science:

  • Medical research
  • Surgical interventions
  • Lymphoedema management

Background:

  • Recurrent cellulitis is a common and difficult complication of lymphoedema.
  • Current guidelines recommend decongestive lymphatic therapy but lack information on surgical interventions.
  • This review investigates the impact of surgery on cellulitis frequency in lymphoedema patients.

Purpose of the Study:

  • To systematically review the effectiveness of surgical interventions in reducing cellulitis attacks in patients with lymphoedema.
  • To assess the impact of various surgical techniques on the incidence of cellulitis.
  • To identify gaps in the evidence base regarding surgical treatments for lymphoedema-related cellulitis.

Main Methods:

  • A systematic literature search was conducted across Embase, Medline, and Cochrane databases up to January 2016.
  • Studies with quantitative data on cellulitis incidence before and after surgery were included.
  • 25 papers were selected for review after initial screening of 436 abstracts.

Main Results:

  • A range of surgical techniques were analyzed, including lymphaticovenous anastomosis and lymph node transfer.
  • Cellulitis incidence decreased after surgical intervention in 24 out of 25 included studies.
  • Quantifiable reductions were reported in eight studies, while 16 studies lacked precise pre-operative incidence data.

Conclusions:

  • Surgical interventions appear to be effective in lowering cellulitis incidence among lymphoedema patients.
  • There is a lack of high-quality evidence, particularly from randomized controlled trials.
  • Future research should focus on comparative studies, such as surgery plus compression versus compression alone, for patients with frequent cellulitis attacks.