{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:04:30Z","timestamp":1773295470465,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T00:00:00Z","timestamp":1638921600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>An innovative wireless device for bioimpedance analysis was developed for post-dual-site free vascularized lymph node transfer (VLNT) evaluation. Seven patients received dual-site free VLNT for unilateral upper or lower limb lymphedema. A total of 10 healthy college students were enrolled in the healthy control group. The device was applied to the affected and unaffected limbs to assess segmental alterations in bioimpedance. The affected proximal limb showed a significant increase in bioimpedance at postoperative sixth month (3.3 [2.8, 3.6], p = 0.001) with 10 kHz currents for better penetration, although the difference was not significant (3.3 [3.3, 3.8]) at 1 kHz. The bioimpedance of the affected distal limb significantly increased after dual-site free VLNT surgery, whether passing with the 1 kHz (1.6 [0.7, 3.4], p = 0.030, postoperative first month; 2.8 [1.0, 4.2], p = 0.027, postoperative third month; and 1.3 [1.3, 3.4], p = 0.009, postoperative sixth month) or 10 kHz current ((1.4 [0.5, 2.7], p = 0.049, postoperative first month; 3.2 [0.9, 6.3], p = 0.003, postoperative third month; and 3.6 [2.5, 4.1], p &lt; 0.001, postoperative sixth month). Bioimpedance alterations on the affected distal limb were significantly correlated with follow-up time (rho = 0.456, p = 0.029 detected at 10 kHz). This bioimpedance wireless device could quantitatively monitor the interstitial fluid alterations, which is suitable for postoperative real-time surveillance.<\/jats:p>","DOI":"10.3390\/s21248187","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T23:30:00Z","timestamp":1639006200000},"page":"8187","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Novel Wireless Bioimpedance Device for Segmental Lymphedema Analysis Post Dual-Site Free Vascularized Lymph Node Transfer: A Prospective Cohort Study"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0463-7346","authenticated-orcid":false,"given":"Chang-Cheng","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, Taichung 404332, Taiwan"},{"name":"School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan"},{"name":"Institute of Imaging and Biomedical Photonics, National Yang Ming Chiao Tung University, Tainan 711010, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Ling","family":"Jan","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, Taichung 404332, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Huei","family":"Juan","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Science, China Medical University, Taichung 404333, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nai-Hsin","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404332, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8653-2571","authenticated-orcid":false,"given":"Bor-Shyh","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Imaging and Biomedical Photonics, National Yang Ming Chiao Tung University, Tainan 711010, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, Taichung 404332, Taiwan"},{"name":"International Medical Service Center, China Medical University Hospital, Taichung 404332, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1002\/micr.30168","article-title":"Double gastroepiploic vascularized lymph node tranfers to middle and distal limb for the treatment of lymphedema","volume":"37","author":"Ciudad","year":"2017","journal-title":"Microsurgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1002\/micr.30508","article-title":"Comparisons in long-term clinical outcomes among patients with upper or lower extremity lymphedema treated with diverse vascularized lymph node transfer","volume":"40","author":"Ciudad","year":"2020","journal-title":"Microsurgery"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"528","DOI":"10.21037\/gs.2020.02.10","article-title":"Gastroepiploic vascularized lymph node transfer for the treatment of extremity lymphedema: Comparison between middle and distal inset","volume":"9","author":"Manrique","year":"2020","journal-title":"Gland Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1002\/jso.25607","article-title":"Vascularized gastroepiploic lymph node transfer significantly improves breast cancer-related lymphedema","volume":"121","author":"Mousavi","year":"2020","journal-title":"J. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1055\/s-0038-1632401","article-title":"Vascularized Lymph Node Transfer for Lymphedema","volume":"32","author":"Schaverien","year":"2018","journal-title":"Semin. Plast. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1002\/jso.24969","article-title":"Staged surgical treatment of extremity lymphedema with dual gastroepiploic vascularized lymph node transfers followed by suction-assisted lipectomy\u2014A prospective study","volume":"117","author":"Agko","year":"2018","journal-title":"J. Surg. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1002\/jso.25360","article-title":"Combined double vascularized lymph node transfers and modified radical reduction with preservation of perforators for advanced stages of lymphedema","volume":"119","author":"Ciudad","year":"2019","journal-title":"J. Surg. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1002\/micr.30641","article-title":"A prospective study on combined lymphedema surgery: Gastroepiploic vascularized lymph nodes transfer and lymphaticovenous anastomosis followed by suction lipectomy","volume":"41","author":"Bolletta","year":"2021","journal-title":"Microsurgery"},{"key":"ref_9","first-page":"720","article-title":"A comprehensive review of bioimpedance spectroscopy as a diagnostic tool for the detection and measurement of breast cancer-related lymphedema","volume":"118","author":"Seward","year":"2018","journal-title":"J. Surg. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1023\/A:1016591121762","article-title":"Reul-Hirche, H.M.; Bullock-Saxton, J.E.; Furnival, C.M. Physiotherapy after breast cancer surgery: Results of a randomised controlled study to minimise lymphoedema","volume":"75","author":"Box","year":"2002","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s10549-004-2045-x","article-title":"Comparison of methods to diagnose lymphoedema among breast cancer survivors: 6-month follow-up","volume":"89","author":"Hayes","year":"2005","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1089\/lrb.2015.0019","article-title":"Experimental and Analytical Comparisons of Tissue Dielectric Constant (TDC) and Bioimpedance Spectroscopy (BIS) in Assessment of Early Arm Lymphedema in Breast Cancer Patients after Axillary Surgery and Radiotherapy","volume":"13","author":"Lahtinen","year":"2015","journal-title":"Lymphat. Res. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/j.ejso.2011.09.001","article-title":"Prevalence of lymphoedema more than five years after breast cancer treatment","volume":"37","author":"Slangen","year":"2011","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.bjps.2018.02.012","article-title":"Diagnostic accuracy of bioimpedance spectroscopy in patients with lymphedema: A retrospective cohort analysis","volume":"71","author":"Qin","year":"2018","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Mihara, M., Hara, H., Araki, J., Kikuchi, K., Narushima, M., Yamamoto, T., Iida, T., Yoshimatsu, H., Murai, N., and Mitsui, K. (2012). Indocyanine green (ICG) lymphography is superior to lymphoscintigraphy for diagnostic imaging of early lymphedema of the upper limbs. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0038182"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1055\/s-0036-1586254","article-title":"Indocyanine Green Lymphographic Evidence of Surgical Efficacy Following Microsurgical and Supermicrosurgical Lymphedema Reconstructions","volume":"32","author":"Chen","year":"2016","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_17","first-page":"43","article-title":"The third circulation: Radionuclide lymphoscintigraphy in the evaluation of lymphedema","volume":"44","author":"Szuba","year":"2003","journal-title":"J. Nucl. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/01.sap.0000244977.84130.cf","article-title":"The use of bioimpedance analysis to evaluate lymphedema","volume":"58","author":"Warren","year":"2007","journal-title":"Ann. Plast. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"10895","DOI":"10.3390\/s140610895","article-title":"The theory and fundamentals of bioimpedance analysis in clinical status monitoring and diagnosis of diseases","volume":"14","author":"Khalil","year":"2014","journal-title":"Sensors"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1177\/0884533614568155","article-title":"Bioimpedance at the bedside: Current applications, limitations, and opportunities","volume":"30","author":"Mulasi","year":"2015","journal-title":"Nutr. Clin. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1089\/lrb.2017.0030","article-title":"Segmental Bioimpedance Informs Diagnosis of Breast Cancer-Related Lymphedema","volume":"15","author":"Svensson","year":"2017","journal-title":"Lymphat. Res. Biol."},{"key":"ref_22","first-page":"2","article-title":"Early diagnosis of lymphedema using multiple frequency bioimpedance","volume":"34","author":"Cornish","year":"2001","journal-title":"Lymphology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1016\/j.pmrj.2011.07.021","article-title":"Segmental limb volume change as a predictor of the onset of lymphedema in women with early breast cancer","volume":"3","author":"Stout","year":"2011","journal-title":"PM R"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2809","DOI":"10.1002\/cncr.23494","article-title":"Preoperative assessment enables the early diagnosis and successful treatment of lymphedema","volume":"112","author":"Pfalzer","year":"2008","journal-title":"Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S1350-4533(02)00194-7","article-title":"A review of electrical impedance techniques for breast cancer detection","volume":"25","author":"Zou","year":"2003","journal-title":"Med. Eng. Phys."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1002\/elps.201900420","article-title":"Evaluation of electrical characteristics of biological tissue with electrical impedance spectroscopy","volume":"41","author":"Yao","year":"2020","journal-title":"Electrophoresis"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1002\/micr.30299","article-title":"A quantitative evaluation with an innovative wireless bio-impedance device to check improvement of limb lymphedema after receiving two-site vascularized lymph node transfer simultaneously in a patient","volume":"38","author":"Chang","year":"2018","journal-title":"Microsurgery"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1089\/lrb.2017.0036","article-title":"Intra- and Inter-Rater Reliability of Bioimpedance in the Evaluation of Lymphedema Secondary to Treatment of Breast Cancer","volume":"16","author":"Ferro","year":"2018","journal-title":"Lymphat. Res. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1089\/lrb.2017.0078","article-title":"Correlation of Bioimpedance Spectroscopy with Risk Factors for the Development of Breast Cancer-Related Lymphedema","volume":"16","author":"Vicini","year":"2018","journal-title":"Lymphat. Res. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/tbj.12647","article-title":"Bioimpedance Spectroscopy for Breast Cancer Related Lymphedema Assessment: Clinical Practice Guidelines","volume":"22","author":"Shah","year":"2016","journal-title":"Breast J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s10549-020-05988-6","article-title":"The impact of monitoring techniques on progression to chronic breast cancer-related lymphedema: A meta-analysis comparing bioimpedance spectroscopy versus circumferential measurements","volume":"185","author":"Shah","year":"2021","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3250","DOI":"10.1245\/s10434-019-07344-5","article-title":"A Randomized Trial Evaluating Bioimpedance Spectroscopy versus Tape Measurement for the Prevention of Lymphedema Following Treatment for Breast Cancer: Interim Analysis","volume":"26","author":"Ridner","year":"2019","journal-title":"Ann. Surg. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2948","DOI":"10.1245\/s10434-018-6601-8","article-title":"Reducing Breast Cancer-Related Lymphedema (BCRL) through Prospective Surveillance Monitoring Using Bioimpedance Spectroscopy (BIS) and Patient Directed Self-Interventions","volume":"25","author":"Kilgore","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1089\/lrb.2020.0097","article-title":"The Early Detection of Breast Cancer Treatment-Related Lymphedema of the Arm","volume":"19","author":"Keeley","year":"2021","journal-title":"Lymphat. Res. Biol."},{"key":"ref_35","first-page":"134","article-title":"Bioimpedance spectroscopy is not associated with a clinical diagnosis of breast cancer-related lymphedema","volume":"52","author":"Spitz","year":"2019","journal-title":"Lymphology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3389\/fonc.2020.00111","article-title":"Feasibility of Bioimpedance Analysis to Assess the Outcome of Complex Decongestive Therapy in Cancer Treatment-Related Lymphedema","volume":"10","author":"Cho","year":"2020","journal-title":"Front. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1177\/0268355520938578","article-title":"Bioimpedance spectroscopy and volumetry in the immediate\/short-term monitoring of intensive complex decongestive treatment of lymphedema","volume":"35","author":"Cavezzi","year":"2020","journal-title":"Phlebology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-020-06059-6","article-title":"Is bioimpedance spectroscopy a useful tool for objectively assessing lymphovenous bypass surgical outcomes in breast cancer-related lymphedema?","volume":"186","author":"Sutherland","year":"2021","journal-title":"Breast Cancer Res. Treat."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/24\/8187\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:43:04Z","timestamp":1760168584000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/24\/8187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,8]]},"references-count":38,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["s21248187"],"URL":"https:\/\/doi.org\/10.3390\/s21248187","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,8]]}}}