Abstract
Background: Lymphoedema is defined as an abnormal collection of excessive tissue proteins, oedema, chronic inflammation, and fibrosis. Lymphoedema occurs, when the lymphatic system is unable to drain the excess lymphatic fluid, resulting in the accumulation and swelling of the territory.
Aims: The aims of this project are to
1. Synthesize the available evidence on non-surgical interventions for primary lower limb lymphoedema.
2. Assess the effectiveness of different non-surgical management approaches.
3. Provide clinical guidance to patients and healthcare providers with a clinical resource that guiders decision-making for evidence-based treatment plans.
Answering the question question: What is non-surgical best practice for primary lower limb lymphoedema (LLL) specialist care?
Methods: This literature review will be conducted using the Integrative Review six-stage framework by Whittemore and Knafl (2005). Fourteen studies met the inclusion criteria, and their results were analysed by thematic analysis.
Results: Two articles were Randomised Controlled Trials, one case report, eight case series, and three Cohort studies were conducted across Europe, the UK, the USA, and Asia. A total of 899 participants were studied across the studies. The interventions of the fourteen articles were aquatic exercise, four studies of complex decongestive therapy, manual lymphatic drainage, two studies of pneumatic compression, three studies of compression therapy, the transdermal delivery of actives, vacuum technology, and pharmacological therapy. These were analysed into four main themes:
1. Complex decongestive therapy.
2. Pneumatic compression.
3. Compression therapy.
4. Miscellaneous therapies.
Conclusion The best-practice non-surgical intervention to improve primary lower limb lymphoedema is to use a multi-intervention approach integrating compression, manual lymphatic drainage, and exercise depending on the severity of the lymphoedema. This literature review facilitates the integration of evidence-based interventions for lymphoedema specialist care into the clinical settings, enhancing patient care and improving patient outcomes.