Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa, Israel.
Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa, Israel; Bruce and Ruth Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.
J Vasc Surg Venous Lymphat Disord. 2024 Jan;12(1):101676. doi: 10.1016/j.jvsv.2023.08.015. Epub 2023 Sep 9.
Lymphedema is a chronic condition caused by impaired lymphatic fluid drainage, resulting in progressive edema. The current mainstay of lymphedema therapy consists of conservative therapy and surgical therapy. In this systematic review, we investigated the novel role of biomaterials in clinical lymphedema therapy and assessed their objective outcomes and the complication rate associated with their use.
Studies were identified through systematic review using the Embase and PubMed/MEDLINE databases. Only original articles reporting the use of biomaterials for clinical lymphedema therapy were included. The primary outcome measure was the objective reduction in limb volume after biomaterial use. The secondary outcome measure was the assessment of biomaterial safety.
A total of 354 articles were identified in the first search, of which 10 met our inclusion criteria. These articles described the use of two biomaterials, nanofibrillar collagen scaffolds (NCSs) and silicone tubes (STs), for the treatment of lymphedema. NCS implantation showed an average excess limb volume reduction of 1% to 10.7% and clear evidence of lymphangiogenesis on imaging. No complications were 7documented after NCS implantation. ST implantation showed an average limb volume reduction of 700 to 887 mL and limb circumference reduction of 3.1 to 8 cm in patients with advanced stage lymphedema. Of 177 patients treated with ST implantation, only 11 (6.2%) developed local inflammation.
Both NCS and ST implantation showed promising limb volume reduction; however, with the scarce literature available, additional research is needed to determine their effectiveness. Both demonstrated good safety profiles, with no complications after NCS implantation and a complication rate equivalent to other similar implants for ST implantation.
淋巴水肿是一种由淋巴液引流受损引起的慢性疾病，导致进行性水肿。目前淋巴水肿治疗的主要方法包括保守治疗和手术治疗。在本系统评价中，我们研究了生物材料在临床淋巴水肿治疗中的新作用，并评估了它们的客观疗效和使用相关的并发症发生率。
通过 Embase 和 PubMed/MEDLINE 数据库进行系统检索以确定研究。仅纳入报告生物材料用于临床淋巴水肿治疗的原始文章。主要结局指标是生物材料使用后肢体体积的客观减少。次要结局指标是生物材料安全性评估。
首次搜索共确定了 354 篇文章，其中有 10 篇符合纳入标准。这些文章描述了两种生物材料，纳米纤维胶原支架（NCS）和硅胶管（ST），用于治疗淋巴水肿。NCS 植入显示平均过度肢体体积减少 1%至 10.7%，并在影像学上显示明确的淋巴管生成证据。NCS 植入后无并发症记录。ST 植入显示晚期淋巴水肿患者肢体体积减少 700 至 887 毫升，肢体周长减少 3.1 至 8 厘米。177 例接受 ST 植入治疗的患者中，仅 11 例（6.2%）发生局部炎症。
NCS 和 ST 植入均显示出有希望的肢体体积减少；然而，由于可用的文献稀少，需要进一步研究来确定它们的有效性。两者均表现出良好的安全性，NCS 植入后无并发症，ST 植入的并发症发生率与其他类似植入物相当。
