{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:16:31Z","timestamp":1777922191324,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cellulitis is frequently encountered in patients with lymphedema despite existing prevention protocols. To resolve this issue, social aspects surrounding patients, such as communication with patients and professionals, are necessary to consider new approaches. This study aimed to clarify the association between the history of cellulitis in patients with lymphedema and access to specialists after adjustment for relevant confounding factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      This study was a secondary analysis of the Lymphoedema IMpact and PRevalence\u2014INTernational (LIMPRINT) study using a national Japanese database of adult lymphedema compiled between 2014 and 2015 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009113). Descriptive data were collected for patient characteristics. Multivariate logistic regression analysis was conducted to explore possible risk factors for patients having experienced cellulitis. The duration of edema ranged from &lt;6 months (16.2%) to 10 years or longer (25.2%), with varying severity. History of cellulitis was observed in 31.9% of patients. The prevalent treatment techniques within the context of complex decongestive therapy included skin care advice (52.2%), compression garments (55.8%), exercise advice (41.6%), multilayer bandages (38.1%), cellulitis advice (49.6%), and massage (61.1%). Overall, 57.1% of patients had access to lymphedema specialists. Longer duration of lymphedema (adjusted odds ratio [AOR]\u2009=\u20094.10,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.005) and access to lymphedema specialists (AOR\u2009=\u20090.28,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.009) were significantly associated with a history of cellulitis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A history of cellulitis in patients with lymphedema is associated with limited access to specialists. To support self-care in this patient population, reasonable consideration systems, including telehealth, should be developed to facilitate communication between specialists and patients and decrease the occurrence of cellulitis in lymphedema.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2021.0056","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T17:20:08Z","timestamp":1632849608000},"page":"442-446","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Association Between Access to Specialists and History of Cellulitis Among Patients with Lymphedema: Secondary Analysis Using the National LIMPRINT Database"],"prefix":"10.1177","volume":"19","author":[{"given":"Misako","family":"Dai","sequence":"first","affiliation":[{"name":"Research Center for Implementation Nursing Science Initiative, School of Health Sciences, Fujita Health University, Aichi, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gojiro","family":"Nakagami","sequence":"additional","affiliation":[{"name":"Department of Gerontological Nursing\/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."},{"name":"Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya","family":"Sato","sequence":"additional","affiliation":[{"name":"Kawasaki City College of Nursing, Kanagawa, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7572-6063","authenticated-orcid":false,"given":"Hiroe","family":"Koyanagi","sequence":"additional","affiliation":[{"name":"Research Center for Implementation Nursing Science Initiative, School of Health Sciences, Fujita Health University, Aichi, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masushi","family":"Kohta","sequence":"additional","affiliation":[{"name":"Research Center for Implementation Nursing Science Initiative, School of Health Sciences, Fujita Health University, Aichi, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2436-0129","authenticated-orcid":false,"given":"Christine J.","family":"Moffatt","sequence":"additional","affiliation":[{"name":"Nottingham University Hospital Care Excellence Institute, Nottingham, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susie","family":"Murray","sequence":"additional","affiliation":[{"name":"Centre for Research and Implementation of Clinical Practice, Nottingham, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J.","family":"Franks","sequence":"additional","affiliation":[{"name":"Centre for Research and Implementation of Clinical Practice, Nottingham, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Sanada","sequence":"additional","affiliation":[{"name":"Department of Gerontological Nursing\/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."},{"name":"Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junko","family":"Sugama","sequence":"additional","affiliation":[{"name":"Research Center for Implementation Nursing Science Initiative, School of Health Sciences, Fujita Health University, Aichi, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,10,15]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-014-0422-0"},{"key":"e_1_3_6_3_2","first-page":"366","article-title":"Cellulitis: Current insights into pathophysiology and clinical management","volume":"75","author":"Cranendonk DR","year":"2017","unstructured":"Cranendonk DR, , Lavrijsen APM, , Prins JM, , Wiersinga WJ. Cellulitis: Current insights into pathophysiology and clinical management. Neth J Med, 2017; 75:366\u2013378.","journal-title":"Neth J Med"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17445"},{"key":"e_1_3_6_5_2","first-page":"3","article-title":"Cellulitis and lymphoedema: A vicious cycle","volume":"4","author":"Al-Niaimi F","year":"2009","unstructured":"Al-Niaimi F, , Cox N. Cellulitis and lymphoedema: A vicious cycle. J Lymphoedema, 2009; 4:3\u201342.","journal-title":"J Lymphoedema"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2018.0080"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg126"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2018.0081"},{"key":"e_1_3_6_9_2","first-page":"170","article-title":"Document C, Congress XVII, et al. The diagnosis and treatment of peripheral lymphedema: 2016 consensus document of the International Society of Lymphology","volume":"49","author":"International Society of Lymphology","year":"2017","unstructured":"International Society of Lymphology. Document C, Congress XVII, et al. The diagnosis and treatment of peripheral lymphedema: 2016 consensus document of the International Society of Lymphology. Acta Angiol, 2017; 49:170\u2013184.","journal-title":"Acta Angiol"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.01.037"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2012.05.003"},{"key":"e_1_3_6_12_2","unstructured":"Moffatt C. Best Practice for the Management of Lymphoedema\u2014International Consensus. (Christine Moffatt DebraDoherty Phil Morgan MacGregor L ed.). 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