{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T16:22:09Z","timestamp":1774714929526,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,8,6]],"date-time":"2015-08-06T00:00:00Z","timestamp":1438819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Reverse Brain Drain Grant"},{"DOI":"10.13039\/501100004192","name":"National Science and Technology Development Agency NSTDA","doi-asserted-by":"crossref","award":["2004-2006"],"award-info":[{"award-number":["2004-2006"]}],"id":[{"id":"10.13039\/501100004192","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Research Project for Technology Transfer of Chronic Lymphedema Treatment Targeting at Medical, Public Health, and Community Personnel in Thailand under Technology Transfer Grant"},{"name":"Faculty of Tropical Medicine"},{"name":"Mahidol Unversity","award":["2007-2009"],"award-info":[{"award-number":["2007-2009"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Twisting Tourniquet<jats:sup>\u00a9<\/jats:sup> or in Thai \u201cSchnogh\u201d is a new invention for compression therapy of lymphedema. Twisting Tourniquet<jats:sup>\u00a9<\/jats:sup> Technique (<jats:styled-content style=\"fixed-case\">TTT<\/jats:styled-content>) is totally noninvasive for lymphedema management. After the amazing successful evidence in the first series of 28 patients, we have conducted preliminary studies in lymphedema clinics. It was found that the combination of gradually increasing constriction force by Schnogh until desired pressure was reached and maintained for 15\u00a0min, followed by a 5\u2010min release, doing repeatedly this compression\u2010decompression for at least 10 sessions a day, can generate acceptable results. The aim of the study was to evaluate the scientific effectiveness and establish a treatment protocol of <jats:styled-content style=\"fixed-case\">TTT<\/jats:styled-content> proposed as a therapeutic approach for clinical management of lymphedema. During 2006\u20132013, from over 3500 patients, 647 with primary\/secondary lymphedema passed inclusion criteria, 307 for upper, and 340 for lower extremity. In the 5\u2010day course of <jats:styled-content style=\"fixed-case\">TTT<\/jats:styled-content>, each day patients underwent 10 sessions of a 15\u2010min compression followed by a 5\u2010min decompression. Vegan diet was encouraged as an adjuvant therapy. Among lymphedema patients whose spectrum of edema severity ranged from mild to gigantic, <jats:styled-content style=\"fixed-case\">TTT<\/jats:styled-content> yielded an average volume reduction rate (VR) at 50.2% and 55.6%, making the average edema reduction volume attained at 463 and 1856\u00a0mL for upper and lower limb, respectively. The uniformed practice by Schnogh which supports a continual compression\u2013decompression maneuver over 3.5\u00a0h daily for five consecutive days could induce an average VR at above half of the swelling in extremities\u00a0of 647 patients. Schnogh is therefore effective in clinical management of lymphedema under <jats:styled-content style=\"fixed-case\">TTT<\/jats:styled-content> treatment of fibroblastic interstitium.<\/jats:p>","DOI":"10.1002\/cam4.498","type":"journal-article","created":{"date-parts":[[2015,8,6]],"date-time":"2015-08-06T13:53:32Z","timestamp":1438869212000},"page":"1514-1524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Twisting Tourniquet<sup>\u00a9<\/sup> Technique: introducing <i>Schnogh<\/i>, a novel device and its effectiveness in treating primary and secondary lymphedema of extremities"],"prefix":"10.1002","volume":"4","author":[{"given":"Narumon","family":"Chanwimalueang","sequence":"first","affiliation":[{"name":"Liver Research Unit Faculty of Tropical Medicine Mahidol University  Bangkok Thailand"},{"name":"Lymphology Institute of Thailand and Lymphedema Day Care Center  Nontaburi Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wichai","family":"Ekataksin","sequence":"additional","affiliation":[{"name":"Liver Research Unit Faculty of Tropical Medicine Mahidol University  Bangkok Thailand"},{"name":"Lymphology Institute of Thailand and Lymphedema Day Care Center  Nontaburi Thailand"},{"name":"Lymphedema Clinic Tokushukai Overseas Medical Cooperation Center Tateyama Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parkpoom","family":"Piyaman","sequence":"additional","affiliation":[{"name":"Liver Research Unit Faculty of Tropical Medicine Mahidol University  Bangkok Thailand"},{"name":"Lymphology Institute of Thailand and Lymphedema Day Care Center  Nontaburi Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gedsuda","family":"Pattanapen","sequence":"additional","affiliation":[{"name":"Lymphology Institute of Thailand and Lymphedema Day Care Center  Nontaburi Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borimas K.","family":"Hanboon","sequence":"additional","affiliation":[{"name":"Lymphology Institute of Thailand and Lymphedema Day Care Center  Nontaburi Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,6]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Lymphatic, lymph and lymphomyeloid complex","author":"Yoffey J. 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