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Indocyanine green near‐infrared lymphangiography for evaluation of effectiveness of edema fluid flow under therapeutic compression
Journal of Biophotonics ( IF 2.0 ) Pub Date : 2017-11-20 , DOI: 10.1002/jbio.201700150
Marzanna T Zaleska 1 , Waldemar L Olszewski 1
Affiliation  

The commonly used modalities for therapy of limb lymphedema are manual lymphatic drainage, manual devices moving edema fluid and intermittent pneumatic compression (IPC). What seems to be necessary for validation of the effect of the compression procedure is imaging of the mobilized moving edema fluid. Picture of edema fluid flow would allow the therapist to use force adjusted to the tissue volume and stiffness differing in various limb regions as well as identify sites of abundant accumulation of fluid requiring more compression. The purpose of the present study was to visualize tissue edema fluid flow during manual drainage, Linforoll massage, IPC and bandaging. To obtain data how high compression pressures should be used to mobilize indocyanine green (ICG)‐stained fluid, concomitantly tissue fluid pressure measurements were performed. The following observations were obtained: (1) the possibility of real‐time observation of edema fluid movement using various compression modalities, (2) the threshold pressures necessary to move edema fluid to be over 80 mm Hg in the compression device and over 40 mm Hg in the tissue fluid and (3) inefficacy of compression in some cases despite applying high compression force. These observations point to the need of ICG lymphangiography before compression therapy in each patient. The images observed during the compression procedure give an insight into the distribution of edema fluid, sites of its accumulation and efficacy of applied external force on fluid mobilization.

中文翻译:

吲哚菁绿近红外淋巴管造影用于评估治疗性压迫下水肿液流动的有效性

治疗肢体淋巴水肿的常用方法是手动淋巴引流、手动装置移动水肿液和间歇性气动加压 (IPC)。验证压缩过程的效果似乎需要的是对移动的运动水肿液进行成像。水肿流体流动的图片将允许治疗师使用根据不同肢体区域不同的组织体积和刚度调整的力,以及识别需要更多压缩的大量流体积聚部位。本研究的目的是在手动引流、Linforoll 按摩、IPC 和包扎期间可视化组织水肿液流。为了获得应该如何使用高压缩压力来动员吲哚菁绿 (ICG) 染色液的数据,同时进行了组织液压力测量。获得了以下观察结果:(1)使用各种加压方式实时观察水肿液运动的可能性,(2)在加压装置中将水肿液移动到超过 80 mm Hg 和超过 40 mm 所需的阈值压力组织液中的汞和 (3) 在某些情况下,尽管施加了高压缩力,但压缩效果不佳。这些观察结果表明需要在每位患者的加压治疗前进行 ICG 淋巴管造影。在压缩过程中观察到的图像可以深入了解水肿液的分布、积聚部位和施加的外力对液体流动的功效。(2) 使加压装置中的水肿液移动到超过 80 毫米汞柱和组织液中超过 40 毫米汞柱所需的阈值压力和 (3) 在某些情况下,尽管施加了高压缩力,但压缩效果不佳。这些观察结果表明需要在每位患者的加压治疗前进行 ICG 淋巴管造影。在压缩过程中观察到的图像可以深入了解水肿液的分布、积聚部位和施加的外力对液体流动的功效。(2) 使加压装置中的水肿液移动到超过 80 毫米汞柱和组织液中超过 40 毫米汞柱所需的阈值压力和 (3) 在某些情况下,尽管施加了高压缩力,但压缩效果不佳。这些观察结果表明需要在每位患者的加压治疗前进行 ICG 淋巴管造影。在压缩过程中观察到的图像可以深入了解水肿液的分布、积聚部位和施加的外力对液体流动的功效。
更新日期:2017-11-20
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