{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T18:29:59Z","timestamp":1763058599815,"version":"3.37.3"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T00:00:00Z","timestamp":1647648000000},"content-version":"vor","delay-in-days":199,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T00:00:00Z","timestamp":1631664000000},"content-version":"tdm","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008130","name":"Pusan National University Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008130","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100008130","name":"Pusan National University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-aps.org"],"crossmark-restriction":true},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>\n          Background During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients\u2019 awareness of surgical treatment for secondary upper extremity lymphedema (UEL).<\/jats:p><jats:p>\n          Methods Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups.<\/jats:p><jats:p>\n          Results Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P&lt;0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003).<\/jats:p><jats:p>\n          Conclusions If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.<\/jats:p>","DOI":"10.5999\/aps.2020.02215","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T02:05:35Z","timestamp":1631757935000},"page":"534-542","update-policy":"https:\/\/doi.org\/10.5999\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The relationship between lymphedema severity and awareness of lymphedema surgery"],"prefix":"10.1055","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8916-9325","authenticated-orcid":false,"given":"Hyun Seung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0268-4667","authenticated-orcid":false,"given":"Yong Chan","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9661-0879","authenticated-orcid":false,"given":"Su Bong","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4633-0043","authenticated-orcid":false,"given":"Chang Ryul","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5762-0559","authenticated-orcid":false,"given":"Jin A","family":"Yoon","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan, Korea"},{"name":"Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4893-3761","authenticated-orcid":false,"given":"Joo Hyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,3,19]]},"reference":[{"key":"ref1","first-page":"515","volume-title":"Pathology of lymphedema.","author":"RP Kataru","year":"2017","edition":"4th ed"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1186\/s40064-016-2300-8","article-title":"Worse and worse off: the impact of lymphedema on work and career after breast cancer","volume":"5","author":"J Boyages","year":"2016","journal-title":"Springerplus"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1055\/s-0036-1584570","article-title":"Understanding the concepts and physiologic principles of lymphatic microsurgery","volume":"32","author":"M Sosin","year":"2016","journal-title":"J Reconstr Microsurg"},{"key":"ref4","first-page":"294","article-title":"Long-standing complications after treatment for cancer of the uterine cervix: clinical significance of medical examination at 5 years after treatment","volume":"16","author":"Y Matsuura","year":"2006","journal-title":"Int J Gynecol Cancer"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"5213","DOI":"10.1200\/JCO.2008.16.3725","article-title":"Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements","volume":"26","author":"SA McLaughlin","year":"2008","journal-title":"J Clin Oncol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1007\/s00259-019-04576-1","article-title":"The feasibility of quantitative parameters of lymphoscintigraphy without significant dermal backflow for the evaluation of lymphedema in post-operative patients with breast cancer","volume":"47","author":"K Kim","year":"2020","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/tbj.12710","article-title":"Effectiveness of decongestive lymphatic therapy in patients with lymphedema resulting from breast cancer treatment regardless of previous lymphedema treatment","volume":"23","author":"M Bozkurt","year":"2017","journal-title":"Breast J"},{"key":"ref8","first-page":"244","article-title":"Lymphatic mapping and lymphedema surgery in the breast cancer patient","volume":"4","author":"KM Patel","year":"2015","journal-title":"Gland 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Tsai","year":"2009","journal-title":"Ann Surg Oncol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.ctrv.2007.11.002","article-title":"Breast cancer-related lymphoedema risk reduction advice: a challenge for health professionals","volume":"34","author":"I Nielsen","year":"2008","journal-title":"Cancer Treat Rev"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1002\/1097-0142(20010915)92:6<1368::AID-CNCR1459>3.0.CO;2-9","article-title":"Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis","volume":"92","author":"JA Petrek","year":"2001","journal-title":"Cancer"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1055\/s-0039-1688537","article-title":"Surgical management of lower extremity lymphedema: a comprehensive review","volume":"52","author":"P Ciudad","year":"2019","journal-title":"Indian J Plast 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Mikami","year":"2011","journal-title":"Lymphology"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1016\/j.bjps.2020.08.055","article-title":"Correlation of ICG lymphography and lymphoscintigraphy severity stage in secondary upper limb lymphedema","volume":"73","author":"JA Yoon","year":"2020","journal-title":"J Plast Reconstr Aesthet Surg"}],"container-title":["Archives of Plastic 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