Interventions for lower-extremity lymphedema
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Complete decongestive physiotherapy (i.e., a noninvasive protocol consisting of skin care, lymph drainage massage, exercises, and compression bandaging1) effectively improves edema, rates of infection, and quality of life in patients with lower-extremity lymphedema. (Strength of Recommendation [SOR]: B, based on prospective cohort studies.) Microsurgery may be effective for patients in whom complete decongestive physiotherapy is ineffective. (SOR: C, based on a systematic review of case series.) There is insufficient evidence about the safety and effectiveness of oral benzopyrones to determine whether they are useful for the treatment of lymphedema. (SOR: A, based on a systematic review.)
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