Case Control Study
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World J Clin Cases. Sep 6, 2022; 10(25): 8827-8836
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.8827
Effectiveness of six-step complex decongestive therapy for treating upper limb lymphedema after breast cancer surgery
Hui-Zhen Zhang, Qiao-Ling Zhong, Hui-Ting Zhang, Qing-Hua Luo, Hai-Lin Tang, Li-Juan Zhang
Hui-Zhen Zhang, Qiao-Ling Zhong, Hui-Ting Zhang, Qing-Hua Luo, Hai-Lin Tang, Li-Juan Zhang, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou 510060, China
Author contributions: Zhang HZ and Zhong QL contributed equally to this work; Zhang HZ, Zhang LJ, and Zhong QL conceived and designed the research; Zhang HZ, Zhong QL and Luo QH collected the data and conducted the research; Zhang HZ, and Tang HL analyzed and interpreted the data; Zhang HZ and Zhong QL wrote the initial paper; Zhang LJ and Zhang HT revised the paper; Zhang LJ had primary responsibility for final content; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Sun Yat-sen University Cancer Center. All procedures performed in studies involving human participants were in accordance with the ethics standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethics standards.
Informed consent statement: Written informed consent was obtained from all individual participants included in this study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement - Checklist of items, and the manuscript was prepared and revised according to the STROBE Statement - Checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Juan Zhang, BSc, Director, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, No. 651 Dongfeng Road East, Guangzhou 510060, China. zhanglij@sysucc.org.cn
Received: March 4, 2022
Peer-review started: March 4, 2022
First decision: April 19, 2022
Revised: May 27, 2022
Accepted: July 25, 2022
Article in press: July 25, 2022
Published online: September 6, 2022
Processing time: 174 Days and 18.8 Hours
Abstract
BACKGROUND

Complex decongestive therapy (CDT) is currently recommended as the standard treatment for lymphedema. CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cancer surgery, and is considered non-invasive, painless and without side effects.

AIM

To determine the effectiveness of a six-step CDT involving a foam granule bandage for the treatment of upper extremity lymphedema pressure after breast cancer surgical intervention.

METHODS

The study included 100 patients with upper extremity lymphedema after breast cancer surgery. The surgical methods were mastectomy plus axillary lymph node dissection and breast preservation plus sentinel lymph node biopsy. The study population was further divided into the experimental group and control group with 50 cases in each group. The control group was given conventional CDT (four-step method), which included skin care, freehand lymphatic drainage, foam granule pressurized bandage, and functional exercise. In the experimental group, a six-step CDT method was applied that involved a foam particle bandage combined with air wave pressure therapy in addition to the four steps of conventional CDT. Patients in both groups were given one course of treatment daily (20 times), and the changes in body moisture and subjective symptoms were measured before and after treatment, preoperatively and 20 times after treatment.

RESULTS

No statistically significant differences in 50-Hz bioelectrical impedance and extracellular moisture ratio were observed between the two groups before treatment, suggesting comparability of the baseline data. After treatment, the 50-Hz bioelectrical impedance of the experimental group was significantly higher than that in the control group, and the extracellular moisture ratio was significantly lower than that in the control group. A comparison of the differences between the two groups before and after treatment indicated that the treatment effect in the experimental group was better than that in the control group. After 20 treatments, according to subjective evaluations, the tightness and swelling of the limbs in the experimental group were significantly reduced as compared with those in the control group.

CONCLUSION

The six-step CDT method can effectively reduce lymphedema, promote lymphatic circulation, and alleviate the subjective symptoms of patients, and thereby improve the quality of life and treatment compliance among patients.

Keywords: Comprehensive deswelling; Foam granule bandage; Breast cancer; Upper limb lymphedema; Air pressure wave therapy

Core Tip: The purpose of this study was to determine the effectiveness of six-step complex decongestive therapy for the treatment of upper limb lymphedema after breast cancer surgery. The results showed that this method could effectively reduce edema of the upper extremity, reduce local tissue congestion, and promote lymph circulation.