Increased prevalence of deep vein thrombosis and mortality in patients with Covid-19 at a referral center in Brazil.

BACKGROUND: Among the multiple complex pathophysiological mechanisms underlying Covid-19 pneumonia, immunothrombosis has been shown to play a key role. OBJECTIVE: The aim of the present study was to assess the monthly prevalence of deep venous thrombosis in a university hospital that admitted 5159 patients with Covid-19 in the medical ward and intensive care unit (ICU) and investigate whether there has been an increase in the prevalence of deep vein thrombosis and dead recently. METHOD: A clinical trial was conducted evaluating 5159 patients admitted to the university hospital, Hospital de Base in São Jose do Rio Preto-Brazil, with a positive test for Covid-19, the prevalence of monthly deep venous thrombosis and the increase in thrombotic and events and mortality in March 2020 to April 2021 compared to the previous January and February with March-April of 2021. The evaluated by Fisher's exact test. RESULTS: The prevalence of deep vein thrombosis varied between the months of 0.26% to 7%, with an average of 2.5%. The months of March and April 2021 had a significant increase in venous thrombosis and mortality in relation to the months of January and February 2021. CONCLUSION: The prevalence of deep venous thrombosis was variable during the months evaluated, since the beginning of Covid-19, but there was a significant increase in these last two months.

Treatment for chest pain intercurrence after breast cancer surgery using Godoy's intermittent skin therapy.

OBJECTIVE: Chest pain and swelling are routinely reported in women after breast cancer treatment and are often not valued by health professionals. In general, these patients suffer and without many effective solutions. The aim of the present study was to report the results of a novel technique for the treatment of chest pain related to breast cancer treatment. METHODS: A clinical trial was conducted involving 25 women with chest pain resulting from the treatment of breast cancer and submitted to treatment for lymphedema at the Godoy School in 2018. Godoy's intermittent dermal therapy was performed on the participants 2-4 h/day for 2 days until the occurrence of a significant improvement or complete resolution of pain (measured using the visual analog pain scale). RESULTS: All patients reported a significant reduction in pain in the first ½ h of treatment (P < 0.0001, Wilcoxon signed-rank test). Six of the 25 patients (24%) reported the absence of pain after treatment on the 1st day and all (100%) reported the absence of pain at the end of treatment on the 2nd day. CONCLUSION: Chronic chest pain in patients having been submitted to treatment for breast cancer can be significantly reduced with Godoy's intermittent skin therapy, achieving standards of normality or near normality within only a few sessions.

One-year mortality rates after minor and major amputations of the lower limbs.

Introduction: Critical limb ischemia is the most severe form of peripheral arterial disease. The anatomic and clinical severity of the disease is often heterogeneous and the choice of treatment is affected by different clinical and patient-related factors. The aim of the present study was to evaluate the mortality rate in a period of 1 year following minor and major amputations and compare the rates with that related to major amputation of lower limbs in 2005. Material and methods: A cross-sectional study evaluated minor and major amputations of the lower limbs at the School Hospital affiliated with the São Jose do Rio Preto School of Medicine in the period from July 2018 to July 2019. It was conducted using the charts of 233 patients who had undergone minor and major amputations of the lower limbs. Results: The 1-year mortality rate was analyzed among 108 patients submitted to minor amputations and the mortality rate of 80 patients submitted to major amputations in 2019 was compared to that among 50 patients submitted to major amputations in 2005. Conclusions: Significant 1-year mortality rates were found following minor and major amputations, with a higher rate among patients submitted to the latter procedure. Moreover, there has been no reduction in the mortality rate among patients submitted to major amputation in the past 15 years.

Elephantiasis and Directed Occupational Rehabilitation.

The aim of the present study was to demonstrate the cure of elephantiasis over a ten-year follow-up period and novel discoveries with directed occupational rehabilitation. A 66-year-old female patient with a history of bilateral lower limb lymphedema reported the aggravation of the condition over the years, reaching stage III (elephantiasis). The physical examination confirmed elephantiasis. The circumference of the left lower limb was 106 cm. Her body weight was 106 kilograms, height was 160 cm, and the body mass index (BMI) was 41.6 kg/m2. The patient was submitted to intensive treatment for three weeks, which led to a 21-kg reduction in weight and 66 cm reduction in leg circumference. Ten years after treatment, the patient has maintained the results with the compression stockings. Elephantiasis can be cured, although lymphedema cannot. The cure of elephantiasis depends on maintaining the treatment of lymphedema after normalization or near normalization. Directed occupational therapy stimulates the search for new activities and a life closer to normality.

Compression therapy: Unna boot applied to venous injuries: an integrative review of the literature. / Terapia compressiva: bota de Unna aplicada a lesões venosas: uma revisão integrativa da literatura.

OBJECTIVE: To analyze the literature related to the types of therapies for venous injuries with emphasis on use of the Unna boot, and to investigate and discuss the main aspects related to its use compared to other techniques. METHOD: Integrative review of the literature of the last five years through searches in the following databases: VHL, LILACS, BDENF, SciELO, MEDLINE/PubMed. RESULTS: Twenty-two publications were identified, with 15,931 cases among adult or elderly individuals, whose mean age was 60 (35-78) years or greater with no sex differences. The Unna boot presented a shorter healing time than the single and two-layer elastic bandage. CONCLUSION: Although other compression techniques may prove to be more efficient than the Unna boot by adding more technology, the boot stands out as a traditional low-cost dressing. Multilayer bandage is a gold standard technique. This review demonstrated the best option may not be the Unna boot, because it requires a higher healing time compared to the multilayer bandage, but it meets the expectation with a high rate of treatment efficiency, also when compared to simple dressing, single or two-layer bandage.

Mobilization of Fluids in the Intensive Treatment of Primary and Secondary Lymphedemas.

BACKGROUND: Lymphedema is a clinical condition resulting from the accumulation of macromolecules in the interstitial space with a consequent buildup of fluids. AIM: The objective of this study was to compare the therapeutic response to treatment that mobilizes fluids between primary and secondary lymphedemas. METHOD: Thirty-three patients with severe leg lymphedema who underwent intensive treatment for five consecutive days in 2013 and 2014 at the Clínica Godoy were evaluated in a prospective clinical trial. Diagnosis was based on the patient's history and physical examination. Treatment consisted of eight hours/day of Mechanical Lymphatic Therapy using an electromechanical device (RAGodoy®) that performs plantar flexion and extension associated with 15 minutes of Cervical Lymphatic Therapy, a technique developed by Godoy and Godoy that involves stimulation in the cervical region and a grosgrain compression stocking alternated with elastic bandages. The unpaired t-test and Fisher's exact test were used for statistical analysis with an alpha error of 5% (p value < 0.05) being considering acceptable. Secondary lymphedema was more prevalent in women (Fisher exact test p value < 0.01). RESULTS: The age of patients with secondary lymphedema was greater than those with primary lymphedema (unpaired t-test: p value < 0.03). The mean volume losses were 64.62% and 48.35% for the patients with secondary and primary lymphedema, respectively (p value < 0.03). CONCLUSION: Women are more prevalent and older in the secondary lymphedema group. Volumetric reductions below the knee are faster with intensive treatment for secondary rather than for primary lymphedema.

Terapia compressiva: bota de Unna aplicada a lesões venosas: uma revisão integrativa da literatura / Terapia compresiva: bota de Unna aplicada a lesiones venosas: una revisión integrativa de la literatura / Compression therapy: Unna boot applied to venous injuries: an integrative review of the literature

RESUMO Objetivo: Analisar a bibliografia relacionada aos tipos de terapias para lesões venosas, enfatizando o uso da bota de Unna, e investigar e discutir os principais aspectos relacionados ao seu uso, comparados aos de outras técnicas. Método: Revisão integrativa da literatura dos últimos 5 anos, por meio de buscas na BVS, LILACS, BDENF, SciELO, MEDLINE/PubMed. Resultados: Foram identificadas 22 publicações, com 15.931 casos entre adultos ou idosos, cuja média de idade foi igual ou superior a 60 (35-78) anos, sem discrepância na porcentagem de gênero. A bota de Unna apresentou um tempo inferior de cicatrização que a bandagem elástica simples e de duas camadas. Conclusão: Embora outras técnicas compressivas possam mostrar-se mais eficientes do que a bota de Unna, por agregar mais tecnologia, a bota se destaca por ser um curativo tradicional de baixo custo. A bandagem multicamada é uma técnica padrão-ouro. Esta revisão mostrou que a bota de Unna pode não ser a melhor opção, por demandar um tempo superior de cicatrização em comparação à bandagem multicamada, mas atende à expectativa com um alto índice de eficiência no tratamento, ainda se comparada ao curativo simples, bandagem simples ou de duas camadas.

RESUMEN Objetivo: Analizar la bibliografía relacionada con los tipos de terapias para lesiones venosas, subrayando el empleo de la bota de Unna, e investigar y discutir los principales aspectos relacionados con el uso, comparados con los de otras técnicas. Método: Revisión integrativa de la literatura de los últimos cinco años, mediante búsquedas en la BVS, LILACS, SciELO, MEDLINE/PubMed. Resultados: Fueron identificadas 22 publicaciones, con 15.931 casos entre adultos o añosos, cuyo promedio de edad fue igual o superior a 60 (35-78) años, sin discrepancia en el porcentaje de género. La bota de Unna presentó un tiempo inferior de cicatrización que el vendaje elástico simple y de dos capas. Conclusión: Aunque otras técnicas compresivas puedan mostrarse más eficientes que la bota de Unna, por agregar más tecnología, la bota se destaca por ser un apósito tradicional de bajo costo. El vendaje multicapa es una técnica regla de oro. Esta revisión mostró que la bota de Unna puede no ser la mejor opción, al demandar un tiempo superior de cicatrización en comparación con el vendaje multicapa, pero atiende a la expectación con un alto índice de eficiencia en el tratamiento, incluso si comparada con el apósito simple, vendaje simple o de dos capas.

ABSTRACT Objective: To analyze the literature related to the types of therapies for venous injuries with emphasis on use of the Unna boot, and to investigate and discuss the main aspects related to its use compared to other techniques. Method: Integrative review of the literature of the last five years through searches in the following databases: VHL, LILACS, BDENF, SciELO, MEDLINE/PubMed. Results: Twenty-two publications were identified, with 15,931 cases among adult or elderly individuals, whose mean age was 60 (35-78) years or greater with no sex differences. The Unna boot presented a shorter healing time than the single and two-layer elastic bandage. Conclusion: Although other compression techniques may prove to be more efficient than the Unna boot by adding more technology, the boot stands out as a traditional low-cost dressing. Multilayer bandage is a gold standard technique. This review demonstrated the best option may not be the Unna boot, because it requires a higher healing time compared to the multilayer bandage, but it meets the expectation with a high rate of treatment efficiency, also when compared to simple dressing, single or two-layer bandage.

Evolution of Skin during Rehabilitation for Elephantiasis Using Intensive Treatment.

The objective of this study is to describe the evolution of the skin during rehabilitation for elephantiasis using intensive treatment. We report on the case of a 55-year-old patient with a seven-year history of leg edema. The patient reported that it began with repeated outbreaks of erysipelas over several years. One leg evolved with significant edema leading to an inability to ambulate and for about one month the patient said that he could not get out of bed. Moreover the patient was obese weighing 130 kilos and with a BMI of 39. Intensive treatment was performed over three weeks resulting in a significant reduction in limb volume. The treatment consisted of Mechanical Lymphatic Therapy (RAGodoy), Cervical Lymphatic Stimulation (Godoy & Godoy technique), and a custom-made inelastic stocking of a grosgrain textile. What caught the attention during therapy were the open wounds resulting from fragmentation of the plaque as the edema reduced; the plaque was about 0.5 cm thick. As the treatment evolved the plaque disappeared and the wounds healed. The limb size decreased by more than 80% in three weeks after which the patient began to be treated in an outpatient setting with ambulation using a grosgrain stocking.

Godoy & Godoy Compression Sleeve in the Treatment of Arm Lymphedema: New Concepts for Materials

ABSTRACT The aim of this work was to study on a new low-elastic textile that fulfilled the criteria of fabrics for the manufacture of compression garments to treat lymphedema. The evolution of Godoy & Godoy compression sleeves was performed by following the patients treated for arm lymphedema. Sixty-six patients with ages ranging from 35 to 83 years and a mean of 58.8 years were included in this study. Diagnosis, by the clinical evaluation confirmed by the volumetry, was defined as a volume difference of more than 200 mL between the arms. All the participants were submitted to treatment sessions once, or two times weekly in an outpatient setting. The material used for the compression sleeve in this study was commercialized in Brazil under the name of Gorgurão(r). When high alterations in the pattern of sleeves were made, the patients were monitored by weekly volumetric assessments. The criterion to maintain the modifications in the design was that the hand did not present with edema. By the end of the study, the design of the sleeve was changed so as not to use compression therapy of the hands in 81.8% of the cases; 12.2% continued with compression of the hand, 3.0% stopped using compression completely and 3.0% used only a glove. Thus, Godoy & Godoy compression sleeves could be an efficient option for compression in the treatment of arm lymphedema as they provided better independence in day-to-day activities.

Estudo-piloto no tratamento do linfedema de membros inferiores com meia de gorgurão / Pilot study on the treatment of lower limb lymphedema using grosgrain socks

Objetivo: o objetivo do presente estudo foi avaliar a redução do linfedema em membros inferiores utilizando meia de gorgurão (não elástica) como forma isolada de tratamento. Método: foram avaliados em ensaios clínicos prospectivos 13 pacientes consecutivos com linfedema em membros inferiores tratados com meia de gorgurão e avaliados pela volumetria na Clínica Godoy em 2012. Foram cinco do sexo masculino e oito do sexo feminino, com idades variando entre 26 e 72 anos, com média de 49,0anos. O critério de inclusão foi ter linfedema grau II em membros inferiores, independentemente da causa; houve também a exclusão de pacientes com histórico de alergias e intolerância a mecanismos de contenção, processos infecciosos ativos, imobilidade articular e outras causas que pudessem interferir nos edemas em geral. O tratamento realizado foi a meia de gorgurão, que é inelástica, confeccionada sob medida, em queo fechamento é feito com ilhós e permite ajustamento pelo próprio paciente. Foi feita volumetria - técnica de mensura por deslocamento de água - no início e em todos os retornos. Para análise estatística foi utilizado o teste-t pareado, sendo considerado erro alfa de 5%. Resultado: o estudo foi aprovado pelo Comitê de Ética em Pesquisa. Detectou-se redução significativa nos pacientes tratados, teste t pareado bicaudal com p.

Objective: the objective of this study was to evaluate lymphedema reduction in lower limbs using grosgrain socks (inelastic) as an isolated form of treatment. Method: 13 consecutive patients with lymphedema in the lower limbs treated with grosgrain socks were evaluated in prospective clinical assays for volumetry in the Godoy Clinic in 2012. There were five male and eight female patients, with ages ranging between 26 and 72 years and average of 49.0 years. The inclusion criterion was presenting grade II lymphedema in the lower limbs regardless of the cause; patients with a history of allergies and intolerance to containment mechanisms, infectious processes, joint immobility, and other causes that could interfere with the edema were excluded. The treatment used grosgrain socks, which are inelastic, custom made and closed through eyelets that allow adjustment by the patient. The volumetric technique was used to measure water-offset at the start and all follow-ups. The paired t-test was used for the statistical analysis considering a 5% alpha error. Results: the study was approved by the Research Ethics Committee. A significant reduction was detected in treated patients, two-tailed paired t-test with p.

Lymphoscintigraphic evaluation of manual lymphatic therapy: the Godoy & Godoy technique.

The objective of this study was to evaluate the transport of radiotracers in lymphatic collectors during manual lymphatic therapy. The legs of four male and two female patients with leg lymphedema were assessed using lymphoscintigraphy before, during and after manual lymphatic therapy. The ages of the patients, treated in Hospital de Base in Sao Jose do Rio Preto, ranged from 42 to 64 years with a mean age of 51.2 years. Consecutive patients with grade II leg lymphedema were enrolled in this study. Patients with lymphedema secondary to lymphadenectomy, active infections and weight greater than 130 kg were excluded. Patients were submitted to manual lymphatic therapy, which consists of the collapsing of capillaries using manual compression which is then slid along the skin in a stroking action in the direction of the lymph flow within lymphatic vessels towards the lymph nodes. Two dynamic studies were performed; the first was over 40 minutes (3 images every 10 minutes) which was immediately followed by an entire body scan. A second dynamic evaluation was performed taking images at 10-second intervals over 2 minutes during manual lymphatic therapy. To evaluate the displacement of radiotracers, the path of lymphatic collectors from the knee to a lymph node in the upper thigh was divided into five similarly sized regions of interest. The concentration of radiotracer was quantified in each of the regions of interest. The paired t-test was used for statistical analysis with an alpha error of 5% (p value < 0.05) being considered statistically relevant. The results show statistically significant differences in the number of particles in all the regions of interest comparing before and after treatment (two-tail paired t-test: p value < 0.0001). Manual lymphatic therapy improves the transport of radiotracers in lymphatic collectors.

Synergistic effect of elastic stockings to maintain volume losses after mechanical lymphatic therapy.

The objective of the current study was to assess whether Venosan elastic stockings have a synergistic effect on the maintenance of results after Mechanical Lymphatic Therapy. Eleven patients with grade II lymphedema of the legs, regardless of cause, were evaluated in the Clinica Godoy between September and November 2012. The participants' ages ranged from 53 to 83 years old with a mean of 65.1 years. Two groups were formed with Group I using Venosan elastic stockings and Group II not using any type of compression therapy. Evaluations of the lymphedematous legs were performed before and after each drainage session using bioimpedance. Patients who wore elastic stockings had a greater volume reduction than those who did not wear stockings (unpaired t-test: P value < 0.001).

New compression mechanism in penile-scrotal lymphedema and sexual rehabilitation.

The objective of this study is to describe a new compression mechanism in the treatment of lymphedema of the penis and scrotum and the ensuing sexual rehabilitation. The patient, a 58-year-old man, had edema of the penile and scrotal region as a result of surgery of the pancreas and spleen and chemotherapy. The patient complained of pain, discomfort, and difficulties to walk and urinate. A clinical diagnosis of lymphedema of the penis and scrotum was reached. Treatment involved the continuous use of a cotton-polyester compression garment for the region together with thorough hygiene skin care. The swelling reduced significantly within a week to almost a normal aspect which was accompanied by clinical improvements of the symptoms. The reduction in penile edema allowed sexual rehabilitation even though erectile dysfunction required the use of a specific medication (sildenafil). In conclusion, simple and low-cost options can improve lymphedema of the penis and scrotum and allow sexual rehabilitation.

Tratamento intensivo do linfedema, pós-tratamento de câncer de mama, em pacientes com lesão neurológica / Intensive treatment of breast cancer-related lymphedema in patients with neurological injuries

O objetivo do presente estudo é relatar o tratamento intensivo do linfedema, após câncer de mama, em paciente com perda da força muscular do membro. Relata-se o caso de uma paciente de 51 anos de idade, que evoluiu com linfedema pós-tratamento do câncer de mama, com mastectomia + esvaziamento axilar + quimioterapia e radioterapia. Após procurar a Clínica Godoy para tratamento em agosto de 2012, foi avaliada com a bioimpedância e volumetria inicial e diária. Realizou tratamento intensivo durante três dias consecutivos, por um período de 6 horas, com Terapia Linfática Manual, Terapia Linfática Mecânica (RA Godoy®) e uso de braçadeira de gorgorão, sendo feitos ajustes diários. Na avaliação inicial, apresentava dor de intensidade 10 (Escala de Dor), parestesia em todo o braço e uma diferença de volume total do edema de 577g em relação ao membro contra-lateral. No primeiro dia de tratamento obteve redução da parestesia com o uso da braçadeira de gorgorão e Terapia Linfática Mecânica; no segundo dia, a dor havia diminuído para a intensidade sete (Escala de Dor); no terceiro dia, a dor diminuiu para intensidade cinco (Escala de Dor) e a diferença de volume total do edema passou a ser de 193g. A paciente retornou para sua casa mantendo as mesmas recomendações e tratamento propostos na clínica. O acompanhamento é feito com avaliações de rotina e orientações sobre a importância do uso da braçadeira de gorgorão e drenagem linfática mecânica.

The aim of this study is to report on the intensive treatment of lymphedema resulting from breast cancer therapy in a 51-year-old patient who experienced loss of muscle strength of the arm. This patient developed lymphedema after a mastectomy, axillary resection, chemotherapy and radiation therapy to treat breast cancer. When the patient arrived at the Clinica Godoy for treatment in August 2012, she was evaluated using bioimpedance and volumetry before and then every day during treatment. Intensive treatment was carried out for six hours per day on three consecutive days employing Manual Lymphatic Therapy, Mechanic Lymphatic therapy (RA Godoy®) and a grosgrain compression sleeve with daily adjustments to the size. In the initial physical examination the patient reported a score for the intensity of pain of 10 (Pain Scale), paresthesia in the entire arm and there was a 577 mL difference in volume due to edema compared to the contralateral limb. On Treatment Day 1 the paresthesia was reduced using the grosgrain sleeve and Mechanical Lymphatic Therapy; on Treatment Day 2, the pain had dropped to an intensity of 7 (Pain Scale); on Treatment Day 3, the pain decreased to an intensity of 5 (Pain Scale) and the difference in the volume of edema was only 193 mL. The patient returned home but followed the recommendations and treatment program used at the clinic. Monitoring was by routine assessments and guidance on the importance of using the grosgrain sleeve and Mechanical Lymphatic Therapy to maintain the results and prevent neurological damage.

Evaluation of a new approach to the treatment of lymphedema resulting from breast cancer therapy.

PURPOSE: The aim of this study was to evaluate a new form of intensive treatment for arm lymphedema. METHODS: A prospective study of 66 patients with breast cancer-related lymphedema was performed. The ages of the patients ranged from 35 to 83 years old with a mean of 58.8 years. Diagnosis of lymphedema was made by physical examination and water-displacement volumetry (a difference of ≥ 200 mL between arms). All the patients were submitted to clinical treatment in an outpatient setting which involved a once-weekly session of 3 to 4h of manual and mechanical lymph drainage, myolymphokinetic activities and exercising using facilitating apparatuses and the use of a medical compression sleeve. Monthly volumetry evaluations were routinely performed. The Student t-test was employed for statistical analysis with an alpha level of 5% (p<0.05) being considered significant. RESULTS: The mean follow-up time between cancer treatment and this study was 12.3 months. A significant reduction in the size of the arms was observed for all patients. The mean difference between the lymphedematous and normal arms of all patients was 553.8 mL at the start of treatment and a mean reduction of 70.1% (388.7 mL) of the edema was achieved (p=0.0001). CONCLUSION: In our experience, this model of treatment appeared efficacious in decreasing and maintaining the reduction in volume of arm in breast cancer-related lymphedema.

Control of lymphorrhea and treatment of warty excrescences in elephantiasis.

The aim of this study is to report the control of lymphorrhea in the intensive treatment of elephantiasis, using an Unna boot. The case of a 29-year-old female patient is reported. This young patient evolved with the more serious form of lymphedema, elephantiasis, after surgical treatment of an abdominal neoplasm and radiotherapy. Warty excrescences were present on both legs and genitalia where lymphorrhea was constant. The patient arrived at the Godoy's Clinic for treatment. She was weighed and perimetric evaluations were made at the start of treatment and thereafter every day during an intensive outpatient treatment of eight hours daily for three weeks. Treatment included manual lymph drainage, mechanical lymph drainage using the RA Godoy device, and the continuous use of compression stockings with adjustments made every three hours. An Unna boot was employed as compression at sites of dermal lesions (warty excrescences) with overlapping use of individualized compression stockings that were individually adapted. The Unna boot was renewed every two days during the first week and every 3 days during the second and third weeks. By the end of this course of treatment, most of the warty excrescences had reduced in size or even disappeared and the lymphorrhea was controlled.

Is lymphostasis an aggravant of lipedema?

A 54-year-old female patient reported that a characteristic of her family was 'fat legs' with postural edema since adolescence. Over the years the patient had been gaining weight with an increase in fatty tissue in the legs and arms. At the age of 24 years she started taking oral contraceptives and noted worse swelling and pain in the lower limbs. She was advised to suspend the use of the contraceptives and to start using a transdermal lymphatic system drug and physical exercise which partially improved the symptoms. Three years ago she noted that the swelling was increasing without improvement and sought a physician who raised the hypothesis of lymphedema and referred her to a specialized center. Lipedema and lymphedema was diagnosed in the physical examination. A 3-day intensive treatment program (8 h daily) was started for lymphedema which included manual and mechanical lymph drainage associated with short-strech (<50 mm Hg) compression stockings custom made using a cotton-polyester fabric. Volumetry and perimetry were performed before starting and after the treatment and the legs were photographed. Volumetric and perimetric reductions were obtained suggesting the involvement of regional cutaneous lymphostasis in this disease.

New method to assess manual lymph drainage using lymphoscintigraphy.

The aim of this study was to describe a new variation of the technique to evaluate lymph drainage utilizing lymphoscintigraphy. A LS scan marks the route of lymphatic vessels and may be used to assess both manual lymph drainage and lymph drainage after using some apparatuses. This evaluation may be dynamic, collecting images whilst performing lymph drainage or static, with scans before and after the lymph drainage procedure.