Analysis of physical therapy in patients who had radical lymphadenectomy for cutaneous melanoma

ABSTRACT

OBJECTIVE: Analyze if patients who had radical lymphadenectomies as a treatment for cutaneous melanoma underwent physiotherapy, observing whether or not lymphedema developed, in addition to observing what techniques were used and whether orientation as to the prevention of lymphedema was received. MATERIALS AND METHODS: We evaluated 84 patients submitted to axillary, inguinal and ilioinguinal lymphadenectomies as a treatment for cutaneous melanoma. The patients enrolled underwent an evaluation consisting of measurement of limb volume by manual perimetry and questions. RESULTS: The majority of patients with lymphedema (78.8 percent) underwent postoperative physical therapy. Somewhat troubling is the fact that only 12 individuals with lymphedema remain under treatment (36.4 percent), while the remaining 21 (63.6 percent) did not undergo physical therapy. The start of physical therapy after a 6-month postoperative period (p = 0.007) and after the onset of lymphedema (p = 0.005), performing manual lymph drainage (p = 0.008) and orientation on elastic sleeve or cuff (p < 0.001) showed statistically significant differences when compared to lymphedema and non-lymphedema patient groups. CONCLUSION: Most patients who had lymphedema underwent physiotherapy treatment. In place of a complete regimen of complex decongestive physical therapy, most patients inadequately substituted their physical therapy with isolated techniques. Most patients received orientation on how to prevent lymphedema.