Leg Volume in Patients with Lipoedema following Bariatric Surgery.

INTRODUCTION: Lipoedema is characterized as subcutaneous lipohypertrophy in association with soft-tissue pain affecting female patients. Recently, the disease has undergone a paradigm shift departing from historic reiterations of defining lipoedema in terms of classic edema paired with the notion of weight loss-resistant leg volume towards an evidence-based, patient-centered approach. Although lipoedema is strongly associated with obesity, the effect of bariatric surgery on thigh volume and weight loss has not been explored. MATERIAL AND METHODS: In a retrospective cohort study, thigh volume and weight loss of 31 patients with lipoedema were analyzed before and 10-18 and ≥19 months after sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Fourteen patients, with distal leg lymphoedema (i.e., with healthy thighs), who had undergone bariatric surgery served as controls. Statistical analysis was performed using a linear mixed-effects model adjusted for patient age and initial BMI. RESULTS: Adjusted initial thigh volume in patients with lipoedema was 23,785.4 mL (95% confidence interval [CI] 22,316.6-25,254.1). Thigh volumes decreased significantly in lipoedema and control patients (baseline vs. 1st follow-up, p < 0.0001 and p = 0.0001; baseline vs. 2nd follow-up, p < 0.0001 and p = 0.0013). Adjusted thigh volume reduction amounted to 33.4 and 37.0% in the lipoedema and control groups at the 1st follow-up, and 30.4 and 34.7% at the 2nd follow-up, respectively (lipoedema vs. control p > 0.999 for both). SG and RYGB led to an equal reduction in leg volume (operation type × time, p = 0.83). Volume reduction was equally effective in obese and superobese patients (weight category × time, p = 0.43). CONCLUSION: SG and RYGB lead to a significant thigh volume reduction in patients with lipoedema.

Evaluation of a novel night-time compression garment: a prospective observational study.

This prospective, single-centre, observational study set out to evaluate the clinical performance and safety of JOBST Relax®, a custom-made compression garment, when worn by a series of patients with lymphoedema during resting hours and at night. Patients were recruited after undergoing complete decongestive therapy (CDT) and wore the night-time compression garment for 21 days as part of their compression therapy regimen. Questionnaires were used to capture their views on parameters such as the garment's comfort, ease of use, fit, ability to avoid excessive heat and perspiration, its effect on their quality of life and their overall satisfaction with it. Occurrences of erythema, skin rash, skin dryness and pain were also evaluated. Ninety-one patients completed the study. Most perceived the night-time compression garment to be 'very good' or 'good' in terms of its ease of use and comfort, its ability to control their oedema and its effect on their quality of sleep. The prevalence of erythema, skin rash, skin dryness and pain was reduced when compared with baseline. Patients also reported that the night-time garment reduced their dependence on others and improved their quality of life. Overall, most rated their satisfaction with the garment as 'very good' or 'good'. Patients reported a high level of satisfaction with both the garment and the comfort associated with it when wearing it frequently.