Role of compression therapy in lipedema

Isabel Forner-Cordero, MD, PhD, Associate Professor Lymphedema Unit, Rehabilitation Department, Hospital Universitari i Politècnic La Fe, University of Valencia, Valencia, Spain Juan Vazquez-Diez, MD Lymphedema Unit, Rehabilitation Department, Hospital General Universitari de Castelló, Castellón de La Plana, Spain ABSTRACT Lipedema is a very frequent chronic disease, frequently underdiagnosed and misdiagnosed and whose pathophysiology is still under research. Patients, most of them women, present with evident disproportion in the distribution of fat between the upper and lower part of the body, swelling, easy bruising, and pain in the lower limbs, and sometimes in the upper limbs. The major aims of its…

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Comparative effectiveness of surgical interventions aimed at treating underlying venous pathology in patients with chronic venous ulcer

Malas MB, Quasi U, Lazarus G, et al. J Vasc Surg: Venous Lymphat Disord. 2014;2:212-25. This review was contracted by the US Agency for Health Care Research and Quality (AHRQ) for the Johns Hopkins Evidence-based Practice Center. Two key questions were developed: 1. For patients with a chronic venous ulcer (CVU), what are the benefits and harms of surgical procedures? 2. For patients with a CVU, what are the comparative benefits and harms of different surgical procedures for a given type of venous reflux and obstruction? A systematic review was conducted and 10 646 citations were identified, of which, 22…

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Skin necrosis as a complication of compression in the treatment of venous disease and in prevention of venous thromboembolism

Michel PERRIN Vascular Surgeon, Chassieu, France BACKGROUND The main concern with compression treatment for chronic venous disease of the lower limb remains compliance, which is difficult to assess depending on the clinical status. Complications like skin allergic reaction and eczema,1 and nerve palsy,2 have been reported, but the most severe is skin necrosis in diabetics or patients with peripheral arterial disease of the lower limbs. There is a consensus for contraindicating compression in patients whose ankle/brachial index (ABI) is less than 0.6, but the arterial disease is not always identified. Diabetes also carries a potential risk of skin wound, but…

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