Cellulitis risk factors for patients with primary or secondary lymphedema

Vignes, S.; Poizeau, Florence; Dupuy, Alain

doi:10.1016/j.jvsv.2021.04.009

Cited by 30 publications

(20 citation statements)

References 26 publications

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“…The garment was well-tolerated and while cellulitis was observed in a number of patients, a prior history of cellulitis was reported for 50% of the study population. Such cellulitis is a well-recognized complication of lymphedema in the lower limb [17]. and also reported in other studies with genital involvement [45].…”

Section: Discussionsupporting

confidence: 61%

“…Clinical characteristics of genital lymphedema are heterogeneous, most patients have swelling in affected genital (penis, scrotum in male, labia in female), pubic or abdominal sites, with lower limb involvement in most of the patients. Skin changes, e.g., papillomatosis, and lymphangiectasia with or without lymphorrea are frequent, while cellulitis is an important, often recurring complication [16,17]. In addition to the dis guring and psychosocial impact, swelling interferes with routine physical activities, urinary and sexual dysfunction is signi cant and may have a substantial impact on health-related quality of life (QoL) [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Positive impact of a new compressive garment in patients with genital lymphedema: OLYMPY STUDY

Mestre

Vignes²,

Malloizel‐Delaunay

et al. 2022

Preprint

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Purpose: Genital lymphedema is a chronic debilitating condition associated with highly impaired health-related quality of life (QoL). This prospective multi-center study evaluated the use of a new compressive garment in patients with secondary and primary genital lymphedema. Methods: 32 patients prospectively enrolled were advised to wear the compressive garment for 12 weeks (day and night). The primary endpoint was change in patient-reported QoL at 12 weeks via the patient global impression of change (PGI-C) instrument. Secondary outcomes included change in other QoL measures at 12 weeks (VAS, LyQLI and EQ-5D questionnaires), lymphedema severity (Genital Lymphedema Score (GLS)) and physician assessment (Clinical Global Impression- Improvement (CGI-I)). Safety and tolerability were also assessed. Results: After 12 weeks, improvement was reported in 78.6% of patients (PGI-C). Physician assessment (CGI-I) indicated clinical improvement in 82.8% of patients. Patient assessment of lymphedema symptoms showed a significant decrease in discomfort (p = 0.02) and swelling (p = 0.01). Significant declines in mean global GLS scores (p < 0.0001), and in the proportion of patients reporting heaviness, tightness, swelling or urinary dysfunction (p < 0.05 for all) were also observed. LyQLI scores decreased (indicating improved QoL) in each of the physical, psychosocial (p = 0.05) and practical domains. The compressive garment was well tolerated with high compliance and adverse events (due to swelling or discomfort) led to permanent discontinuation in only 3 patients. Conclusions: Use of a new genital compression garment over 12 weeks improves QoL and clinical measures in patients with genital lymphedema (NCT04602559; Registration: 10/20/2020).

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Positive impact of a new compressive garment in patients with genital lymphedema: OLYMPY STUDY

Mestre

Vignes²,

Malloizel‐Delaunay

et al. 2022

Preprint

Self Cite

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“…Over one in four patients with breast cancer have lymphedema. 27 , 55 , 56 Cellulitis in cancer can also occur in atypical sites such as periorbital and septal cellulitis. 57 Neutropenia also predisposes to infections from atypical fungal organisms, and more severe and invasive bacterial skin infections.…”

Section: Risk Factors For Recurrent Cellulitismentioning

confidence: 99%

Recurrent Cellulitis: Who is at Risk and How Effective is Antibiotic Prophylaxis?

Ong¹,

Dotel²,

Ngian³

2022

IJGM

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Recurrent cellulitis following successful treatment is common and prevention should be a major component in the management of cellulitis. Conditions that increase the risk of recurrence include chronic edema, venous disease, dermatomycosis and obesity. These risk factors should be actively managed as further episodes of cellulitis increases the risk of recurrence. The role of non-antibiotic measures is important and should be first-line in prevention. Antibiotic prophylaxis is effective, but its role is limited to non-purulent cellulitis where risk factors are appropriately managed.

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“…Treatment for LEL is important to maintain limb size and health and reduce the risk of skin infections 2 . Cellulitis is common among those with LEL, with previous studies reporting occurrences in 30% to 72% of patients, and often with recurrences 3 – 5 . The use of compression devices can reduce the risk of cellulitis and help to avoid costly healthcare encounters 14 – 17 in addition to decreasing edema volume 20 .…”

Section: Discussionmentioning

confidence: 98%

“…While secondary lymphedema is often thought of as a result of cancer treatment, venous disorders have been underrecognized as a cause and may, in fact, be the most common cause of LEL in the US 3 , 4 . Progression of LEL often results in cellulitis and infections 2 – 5 , which can further worsen lymphatic drainage that will exacerbate edema 2 . Other skin ailments, such as hyperkeratosis and papillomatosis can also occur 2 .…”

Section: Introductionmentioning

confidence: 99%

A non-randomized, open-label study of the safety and effectiveness of a novel non-pneumatic compression device (NPCD) for lower limb lymphedema

Rockson

Karaca‐Mandic

Nguyen³

et al. 2022

Sci Rep

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Lower extremity lymphedema (LEL) can result in detriments to quality of life (QOL) and impose a significant economic burden on patients and payers. A common component of treatment is pneumatic compression, which requires patients to remain immobile. We investigated a novel non-pneumatic compression device (NPCD) that allows patients to remain active during compression treatment, to see if it reduces swelling and improves QOL. We conducted a non-randomized, open-label, 12-week pilot study of adult patients with primary or secondary unilateral LEL, and measured changes in limb edema and QOL using the Lymphedema Quality of Life Questionnaire (LYMQOL). Twenty-four subjects were enrolled; the majority were female (17) with secondary lymphedema (21). Eighteen completed the study. Statistically significant improvements were observed in overall QOL, aggregated LYMQOL total score, and three of four LYMQOL subscales (Function, Appearance, Mood). The fourth (Symptoms) trended toward significant improvement (p = 0.06). The average reduction in affected limb edema was 39.4%. The novel NPCD produced statistically significant improvements in QOL, functioning, and edema volume of patients with LEL. Innovations in devices to manage LEL can be effective while allowing patients to maintain mobility and physical activity during treatment.

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Cellulitis risk factors for patients with primary or secondary lymphedema

Cited by 30 publications

References 26 publications

Positive impact of a new compressive garment in patients with genital lymphedema: OLYMPY STUDY

Positive impact of a new compressive garment in patients with genital lymphedema: OLYMPY STUDY

Recurrent Cellulitis: Who is at Risk and How Effective is Antibiotic Prophylaxis?

A non-randomized, open-label study of the safety and effectiveness of a novel non-pneumatic compression device (NPCD) for lower limb lymphedema

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