| 1. |
- Brorson, Håkan, et al.
(författare)
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Suction-assisted lipectomy
- 2015
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Ingår i: Lymphedema : Presentation, Diagnosis, and Treatment - Presentation, Diagnosis, and Treatment. - Cham : Springer International Publishing. - 9783319144924 - 9783319144931 ; , s. 313-324
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Bokkapitel (refereegranskat)abstract
- 39.Brorson H, Svensson B, Ohlin K. Suction-Assisted Lipectomy. In: Greene AK, Slavin S, Brorson H, editors, Lymphedema - Presentation, Diagnosis, and Treatment. Cham, Switzerland: Springer; 2015: p. 313-324.
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| 2. |
- Greene, Arin K, et al.
(författare)
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Uncommon procedures for lymphedema
- 2015
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Ingår i: Lymphedema : Presentation, Diagnosis, and Treatment - Presentation, Diagnosis, and Treatment. - Cham : Springer International Publishing. - 9783319144924 - 9783319144931 ; , s. 243-246
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Bokkapitel (refereegranskat)
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| 3. |
- Ohlin, Karin, et al.
(författare)
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Controlled compression therapy and compression garments
- 2015
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Ingår i: Lymphedema : Presentation, Diagnosis, and Treatment - Presentation, Diagnosis, and Treatment. - Cham : Springer International Publishing. - 9783319144924 - 9783319144931 ; , s. 213-225
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Bokkapitel (refereegranskat)
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| 4. |
- Johansson, Karin, et al.
(författare)
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Axillary Web Syndrome : Evidence for Lymphatic Origin with Thrombosis
- 2020
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Ingår i: Lymphatic Research and Biology. - : Mary Ann Liebert Inc. - 1539-6851 .- 1557-8585. ; 18:4, s. 329-332
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Tidskriftsartikel (refereegranskat)abstract
- Background: The axillary web syndrome (AWS) occurs in the axilla and on the frontal side of the upper arm and sometimes along the forearm to the thumb. The cord is painful, particularly on movement, and can therefore be very distressing for the patient. Although the phenomenon has been examined and discussed for decades, no evidence for the origin has been found until now. The aim of this study was to perform a histopathologic analysis of cords taken between 1996 and 1998 in the Surgical Clinic, Skane University Hospital, Lund, Sweden. Methods and Results: In seven patients, biopsies of the AWS cords were obtained 4-5 weeks after axillary node surgery for breast cancer and examined with standard hematoxylin and eosin and D2-40 (lymphatic endothelial cell) staining. In one biopsy, there was a dilated vessel with a thickened wall, which was confirmed by D2-40 immunostaining to represent a lymphatic vessel. The lumen was occluded by organized thrombus, within which new vessels were being formed, indicating recanalization. In two other biopsies, similar lymphatic vessels with thickened walls were present, although the lumen of the vessels was not visualized in the planes of the section. The other four biopsies do not show specific features. Conclusion: Although only one case, this is the first pathological evidence of thrombosis within a confirmed lymphatic vessel from a case of cording. We propose that the axillary cord represents lymphatic vessel thrombosis. Recanalization of the thrombus may eventually restore lymphatic flow consistent with the transient nature of the condition.
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| 5. |
- Brorson, Håkan
(författare)
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Liposuction and Controlled Compression Therapy in the Treatment of Arm Lymphedema following Breast Cancer
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Liposuction and controlled compression therapy in the treatment of arm lymphedema following breast cancer About one-third of all women treated for breast cancer develop arm lymphedema. The cancer itself is a worry, but the swollen and heavy arm is an additional handicap for the patients, both physical and psychosocial. Previous surgical and conservative treatments have not always given satisfactory and permanent results, conceivably because lymphedema causes hypertrophy of the subcutaneous adipose tissue. From this point of view, liposuction (LS) combined with Controlled Compression Therapy (CCT) is an interesting approach as the hypertrophied adipose tissue is effectively removed and the outcome sustained by wearing a compression garment. Altogether 51 women participated in the present investigations. All, except one had received radiotherapy after the breast cancer operation which included the excision of axillary lymphnodes in all cases. Thirty-six patients were treated with LS and postoperative CCT, whereas 15 received CCT only. Pre- and postoperative arm edema volumes were measured using water displacement technique. Skin blood flow was recorded using laser Doppler imaging. Lymph transport in the arm was assessed with indirect lymphoscintigraphy. Rage of motion in the shoulder joint was measured using a protractor. Effects on quality of life were estimated using the Visual Analogue Scale, Nottingham Health Profile, Psychological General Well-Being index, and the Hospital Anxiety Depression scale. Results were monitored for up to one year after treatment. LS+CCT reduced the arm edema volume completely, compared with a 50% decrease following CCT alone. The use of a compression garment after liposuction is necessary to maintain the normalized arm volume. LS+CCT did not affect the already impaired lymph transport; it merely increased skin microcirculation. A reduced incidence of cellulitis was noted. The treatment improved range of motion in the shoulder joint and patients' quality of life, particularly qualities directly related to the volume reduction and thereby qualities associated with everyday activities. As could be expected from the volume measurements, the more favorable outcomes were recorded mostly in the LS+CCT group.
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| 6. |
- Brorson, Håkan, et al.
(författare)
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Lymphoedema
- 2008
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Ingår i: Scandinavian Plastic Surgery. - 9789144020358 ; , s. 345-356
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Bokkapitel (refereegranskat)
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| 7. |
- Nordqvist, Gunnar, et al.
(författare)
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Ten years of treating necrotizing fasciitis.
- 2015
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Ingår i: Infectious Diseases. - : Informa UK Limited. - 2374-4243 .- 2374-4235. ; 47:5, s. 319-325
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Tidskriftsartikel (refereegranskat)abstract
- Background: Necrotizing fasciitis is a soft tissue infection characterized by rapid progression and a high mortality rate. The objective of this study was to investigate diagnosis, causative microbial agents, comorbidities, antibiotic regimen and outcome regarding this disease at Skåne University Hospital in Malmö, Sweden. Methods: From medical records, we identified 33 patients treated from January 2003 to January 2013, 31 of whom could be included in our investigation. Results: The infections were monomicrobial in 87% of the cases, and most were caused by group A streptococci. The rate of polymicrobial infections was lower than in other studies. In addition to blood and wound cultures, a rapid antigen detection test for group A streptococci was used in a majority of the cases as a supplement to other diagnostic tools. The time from onset of symptoms to surgery proved to be significantly shorter for patients infected with group A streptococci than for other patients. The mortality rate among all patients was 19%, which is lower than much of the historical material but in line with some more recent studies of this disease. Conclusions: Our results indicate that low mortality rates can be achieved by surgery, appropriate antibiotics and good supportive care. Furthermore, we show that the use of the rapid antigen detection test for group A streptococci, in this setting, helps to shorten the time to surgical intervention in patients suffering from necrotizing fasciitis. This also helps to guide the antibiotic treatment into a narrower spectrum.
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| 8. |
- Boyages, John, et al.
(författare)
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Liposuction for Advanced Lymphedema: A Multidisciplinary Approach for Complete Reduction of Arm and Leg Swelling
- 2015
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Ingår i: Annals of Surgical Oncology. - : Springer Science and Business Media LLC. - 1534-4681 .- 1068-9265. ; 22, s. 1263-1270
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. This research describes and evaluates a liposuction surgery and multidisciplinary rehabilitation approach for advanced lymphedema of the upper and lower extremties. Methods. A prospective clinical study was conducted at an Advanced Lymphedema Assessment Clinic (ALAC) comprised of specialists in plastic surgery, rehabilitation, imaging, oncology, and allied health, at Macquarie University, Australia. Between May 2012 and 31 May 2014, a total of 104 patients attended the ALAC. Eligibility criteria for liposuction included (i) unilateral, non-pitting, International Society of Lymphology stage II/III lymphedema; (ii) limb volume difference greater than 25 %; and (iii) previously ineffective conservative therapies. Of 55 eligible patients, 21 underwent liposuction (15 arm, 6 leg) and had at least 3 months postsurgical follow-up (85.7 % cancer-related lymphedema). Liposuction was performed under general anesthesia using a published technique, and compression garments were applied intraoperatively and advised to be worn continuously thereafter. Limb volume differences, bioimpedance spectroscopy (L-Dex), and symptom and functional measurements (using the Patient-Specific Functional Scale) were taken presurgery and 4 weeks postsurgery, and then at 3, 6, 9, and 12 months postsurgery. Results. Mean presurgical limb volume difference was 45.1 % (arm 44.2 %; leg 47.3 %). This difference reduced to 3.8 % (arm 3.6 %; leg 4.3 %) by 6 months postsurgery, a mean percentage volume reduction of 89.6 % (arm 90.2 %; leg 88.2 %) [p < 0.001]. All patients had improved symptoms and function. Bioimpedance spectroscopy showed reduced but ongoing extracellular fluid, consistent with the underlying lymphatic pathology. Conclusions. Liposuction is a safe and effective option for carefully selected patients with advanced lymphedema. Assessment, treatment, and follow-up by a multidisciplinary team is essential.
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| 9. |
- Hansson, Emma, et al.
(författare)
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Histology of adipose tissue inflammation in Dercum's disease, obesity and normal weight controls: a case control study.
- 2011
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Ingår i: Journal of Inflammation. - : Springer Science and Business Media LLC. - 1476-9255. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dercum's disease (DD) is characterised by obesity and chronic pain (> 3 months) in the adipose tissue. The pathogenesis of DD is unknown, but inflammatory components have been proposed. In previous reports and studies, an inconsistent picture of the histological appearance of the adipose tissue in DD has been described. The aim of this investigation was to examine the histological appearance of adipose tissue in patients with DD, with particular focus on inflammatory signs. METHODS: Fat biopsies were sampled from painful regions from 53 patients with DD. In 28 of the patients, a control adipose tissue biopsy was taken from a location where the patient did not experience any pain. In addition, fat biopsies were sampled from 41 healthy pain-free obese control patients and 11 healthy pain-free normal weight control patients. The extent of inflammation was evaluated on histological sections stained with haematoxylin-eosin. RESULTS: There was no statistically significant difference in the extent of inflammation between the biopsies from the painful knee and the biopsies from the non-painful area (p = 0.5), nor between the biopsies from the abdomen, and the biopsies from the non-painful area (p = 0.4), in patients with DD. A statistically significant difference in extent of inflammation was observed between DD and obese control patients regarding the abdomen (p = 0.022), but not the knee (p = 0.33). There were no differences in extent of inflammation between DD patients and normal weight controls (p = 0.81). CONCLUSION: The findings suggest that there is an inflammatory response in the adipose tissue in DD. However, this response is not more pronounced than that in healthy obese controls. This contradicts inflammation as the aetiology of DD.
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| 10. |
- Hoffner, Mattias, et al.
(författare)
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SF-36 Shows Increased Quality of Life Following Complete Reduction of Postmastectomy Lymphedema with Liposuction
- 2017
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Ingår i: Lymphatic Research and Biology. - : Mary Ann Liebert. - 1539-6851 .- 1557-8585. ; 15:1, s. 87-98
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Tidskriftsartikel (refereegranskat)abstract
- Background: Arm lymphedema after breast cancer surgery affects women both from physical and psychological points of view. Lymphedema leads to adipose tissue deposition. Liposuction and controlled compression therapy (CCT) reduces the lymphedema completely. Methods and Results: Sixty female patients with arm lymphedema were followed for a 1-year period after surgery. The 36-item short-form health survey (SF-36) was used to assess health-related quality of life (HRQoL). Patients completed the SF-36 questionnaire before liposuction, and after 1, 3, 6, and 12 months. Preoperative excess arm volume was 1365 +/- 73mL. Complete reduction was achieved after 3 months and was sustained during follow-up. The adipose tissue volume removed at surgery was 1373 +/- 56mL. One month after liposuction, better scores were found in mental health. After 3 months, an increase in physical functioning, bodily pain, and vitality was detected. After 1 year, an increase was also seen for social functioning. The physical component score was higher at 3 months and thereafter, while the mental component score was improved at 3 and 12 months. Compared with SF-36 norm data for the Swedish population, only physical functioning showed lower values than the norm at baseline. After liposuction, general health, bodily pain, vitality, mental health, and social functioning showed higher values at various time points. Conclusions: Liposuction of arm lymphedema in combination with CCT improves patients HRQoL as measured with SF-36. The treatment seems to target and improve both the physical and mental health domains.
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