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Panminerva Medica 1999 March;41(1):10-14

lingua: Inglese

The edema test­er in the eval­u­a­tion of swol­len limbs in ­venous and lym­phat­ic dis­ease

Cesarone M. R., Belcaro G., Nicolaides A. N., Arkans E., Laurora G., De Sanctis M. T., Incandela L.

From the Microcirculation Laboratory Cardiovascular Institute Chieti University PAP/PEA Institute, San Valentino, Pescara Angiology & Vasc. Surgery & Clinical Trial Unit Pierangeli Clinic, Pescara, Italy and Irvine Laboratory St. Mary’s Hospital and Imperial College, London, UK


Background. Edema is a ­common con­di­tion in ­most ­venous and lym­phatic dis­eases. The ACI ­edema ­testers (ET) ­have ­been devel­oped to objec­tively eval­uate the pres­ence of ­edema. Two ­types of ­testers ­have ­been devel­oped. ET1 is a ­soft ­plastic ­plate (5×2 cm) char­ac­ter­ised by two par­allel pro­tru­sions ­while the ET2 is char­ac­ter­ised by two ­lines of 7 ­holes.
Methods. The ETs are ­applied ­onto the ­internal per­i­mal­le­olar ­region ­with the pro­tru­sions/­holes in con­tact ­with the ­skin. A ­blood pres­sure ­cuff is ­applied ­over the ­area (pres­sure main­tained at 50 mmHg for a ­period ­between 1-3 min­utes). When the ­cuff is ­removed, with the ET1 ­skin ­marks are usu­ally ­just vis­ible in ­normal ­limbs (­they dis­ap­pear in a few min­utes). We ­studied 22 ­normal ­limbs, 19 ­with var­i­cose ­veins, 22 ­with ­chronic ­venous insuf­fi­ciency, 5 ­with pri­mary lym­phedema and 8 ­with ­severe ­chronic lym­phedema.
Results. In ­limbs ­with ­severe ­edema the ­whole ­length of the pro­tru­sions is vis­ible; ­with mod­erate ­edema ­only a ­part of the pro­tru­sions is vis­ible. With the ET2 ­skin ­marks are ­just vis­ible in ­normal ­limbs (­only the ­larger ­holes). Marks dis­ap­pear in a few min­utes in ­normal ­limbs ­while in ­limbs ­with ­edema the ­number of vis­ible ­holes is ­increased (in ­severe ­edema all ­holes are vis­ible). There ­were sig­nif­i­cant dif­fer­ences ­between nor­mals and ­patients (con­sid­ering ­skin ­mark ­length, ­number of vis­ible ­holes and dis­ap­pear­ance ­times).
Conclusions. The two ­testers sep­ar­ated ­patients ­with dif­ferent ­severity of ­edema due to ­chronic ­venous or lym­phatic prob­lems. In ­severe lym­phatic prob­lems all param­e­ters ­were dif­ferent (p<0.02) ­from ­those ­observed in ­venous dis­ease. A repro­du­cibility ­study indi­cated ­that the ET ­tests ­have min­imal vari­a­tions in ­mark vis­ibility or ­length or ­hole num­bers (for the ET2).

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