A scoping literature review of post-traumatic lymphedema: Where are we now?

Post-traumatic lymphedema of the extremities is a significant source of morbidity largely unrecognized by practitioners. Given the unclear body of evidence on diagnosing and managing post-traumatic lymphedema, we performed a systematic scoping review of the literature for all reports on this topic in order to establish a benchmark for current knowledge, treatment modalities, patient outcomes, and future areas of research. After screening 733 titles and abstracts, 16 relevant articles were ultimately selected for analysis, producing 19 data entries. Study designs largely consisted of case reports and case series. The most frequently reported injuries included burns (n = 12), motor vehicle accidents (n = 7), degloving injuries (n = 6), and open tibial fractures (n = 4). A majority of patients were managed with compression therapy. Among patients pursuing surgical intervention, 15 underwent free tissue transfer and 2 underwent lymphovenous anastomoses. All patients had clinical improvement of their lymphedema.With clinical advances in our understanding of lymphedema and its medical and surgical treatments, it is critical that we identify patients in a timely manner to be able to provide them with the best medical care as well as identify areas of future research. We believe that patients with post-traumatic lymphedema are currently largely unrecognized and that collaboration as well as further research will allow for optimized outcomes in this population.