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ePaper created 2014-09-15, 12:31:02 | version 1.32.01
Since 1999, the research programme has developed in an organic way. Most of the research subjects were initiated in order to understand the mechanisms of compression in lymphedema, infection related to lymphedema, and to develop and improve surgical procedures. A method to measure arm lymphedema was developed and validated.[2] In close and fruitful cooperation with Prof. Dr. H. Partsch (Vienna) the mechanism of compression, which is the cornerstone in lymphedema treatment, was analyzed. New treatment programmes and compression techniques were studied.[3-5] Research in the field of primary lymphedema resulted in a better understanding of defects in the FOXC2 pathway, and also an algorithm for children with lymphedema.[6,7] In patients with unilateral erysipelas (without diabetes or chronic venous insufficiency) we found that almost 80% had bi-lateral lymphatic impairment.[8] This was a first clue as to the effectiveness of compression therapy in post-erysipelas patients. In our research programme, we studied new interventions in arm lymphedema. A study of lymph shunts showed no effectiveness in this method, but a new technique of circumferential, suction-assisted lipectomy in a multidisciplinary setting gave 100% long-lasting reduction in arm volume.[9,10] References 1. Damstra RJ. Diagnostic and therapeutical aspects of lymphedema. Second edition. Rabe verlag, Medical publishing, Bonn, Germany. 2013. ISBN 978-3-940654-29-8. 2. Damstra RJ, Glazenburg EJ, Hop WCJ. Validation of the inverse water volumetry method: A new gold standard for arm volume measurements. Breast Cancer Res Treat 2006; 99: 267–73. 3. Damstra RJ, Partsch H. Compression therapy in breast cancer-related lymphedema: A randomized, controlled comparative study of relation between volume and interface pressure changes. J Vasc Surg 2009; 49: 1256–63. 4. Partsch H, Damstra RJ, Mosti G. Dose finding for an optimal compression pressure to reduce chronic edema of the extremities. Int Angiol. 2011; 30(6): 527–33. 5. Damstra RJ, Partsch H. Prospective, randomized controlled trial comparing the effectiveness of adjustable compression Velcro wraps vs inelastic multicomponent compression bandages in the initial treatment of leg lymphedema. Journal of Vascular Surgery: Venous and Lymphatic Disorders 2013; 1: 13–9. 6. Steensel MAM van, Damstra RJ, Heitink MV, et al. Novel missense mutations in the FOXC2 gene alter transcriptional activity. Hum Mutat. 2009; 30(12):E1002–9. 7. Damstra RJ, Mortimer PS. Diagnosis and therapy in children with lymphoedema. Phlebology 2008; 23: 276-86. 8. Damstra RJ, van Steensel MAM, Boomsma JHB, et al. Erysipelas as a sign of subclinical primary lymphoedema: a prospective quantitative scintigraphic study of 40 patients with unilateral erysipelas of the leg. Br J Dermatol 2008; 158: 1210–5. 9. Damstra RJ, Voesten HGJ, van Schelven WD, et al. Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature. Breast Cancer Res Treat 2009; 113: 199–206. 10. Damstra RJ, Voesten HGJM, Klinkert P, Brorson H. Circumferential suction-assisted lipectomy for lymphoedema after surgery for breast cancer. British J Surg 2009; 96: 859–64. 156 BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:41 Pagina 156