Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy.
Physical Medicine and Rehabilitation Unit, Santa Caterina Novella Hospital, 73013 Lecce, Italy.
Int J Environ Res Public Health. 2021 Oct 2;18(19):10383. doi: 10.3390/ijerph181910383.
Axillary web syndrome (AWS) is defined as a visible and palpable network of cords in the skin of the axillary cavity that are tensed by shoulder abduction following surgery for breast cancer, causing significant functional limits of the ipsilateral upper limb (UL) and pain. The purpose of this narrative review is to discuss rehabilitation approaches for greater efficacy with respect to pain and novel suggestions. AWS is a frequent complication of axillary lymphadenectomy that necessitates a thorough follow-up in the medium to long term. Physiotherapy is effective in the treatment of functional limb deficits, the management of pain, and the treatment of upper limb disability. The best management approach involves the use of soft tissue techniques to slow the natural course of the syndrome, in association with therapeutic exercises for functional recovery and muscle strengthening. AWS is linked secondary lymphedema, requiring integration with manual lymphatic drainage. The physiotherapy management of AWS is currently fragmented, and insufficient information is available on the nature of the disease. Thus, randomized and controlled studies that compare rehabilitation approaches in AWS are desirable, including the possibility of using mesotherapy in the treatment of axillary and upper limb pain.
腋网综合征（AWS）定义为乳腺癌手术后，由于肩部外展导致腋腔皮肤中的可见可触及的条索紧张，从而导致同侧上肢（UL）功能受限和疼痛。本叙述性综述的目的是讨论康复方法，以期在疼痛和新建议方面更有效。AWS 是腋窝淋巴结清扫术的常见并发症，需要在中至长期进行彻底随访。物理疗法在治疗功能肢体缺陷、管理疼痛和治疗上肢残疾方面有效。最佳的管理方法涉及使用软组织技术来减缓该综合征的自然进程，同时进行治疗性运动以恢复功能和增强肌肉力量。AWS 与继发性淋巴水肿有关，需要与手动淋巴引流相结合。AWS 的物理治疗管理目前较为分散，对该疾病的性质缺乏足够的信息。因此，需要开展比较 AWS 康复方法的随机对照研究，包括在治疗腋窝和上肢疼痛时使用中胚层疗法的可能性。
