Evaluation of Prophylactic Negative Pressure Therapy in the Murine Hindlimb Lymphedema Model

Authors:
  • GMGanesh Mohan
    Ganesh Mohan
  • DKDaniel J. Konig
    Daniel J. Konig
  • CSChristopher A. Subi-Kasozi
    Christopher A. Subi-Kasozi
  • SSSteven Sullivan
    Steven Sullivan
  • ASAngad S. Sidhu
    Angad S. Sidhu
  • MJMiguel D. Jorge
    Miguel D. Jorge
  • HSHelen C. Sinex
    Helen C. Sinex
  • MMMarc S. Mendonca
    Marc S. Mendonca
  • AGArin K. Greene
    Arin K. Greene
  • AHAladdin H. Hassanein
    Aladdin H. Hassanein
Publisher website
Google Scholar
Abstract
Introduction: Lymphedema is limb swelling secondary to lymphatic injury. Utilization of negative pressure therapy (NPT) has been shown to stimulate lymphatic vessel density, but the effect of NPT on secondary lymphedema is unknown. The purpose of this study was to evaluate the role of prophylactic NPT in murine hindlimb lymphedema model. Methods: The murine hindlimb model of lymphedema was used. Mice underwent 20-Gy irradiation of one hindlimb. One-week post-radiation, an incision in the proximal hindlimb was created to disrupt lymphatic vessels and remove popliteal lymph nodes. Mice were divided into two groups: group 1 (NPT) and group 2 (no NPT). Group 1 received a negative pressure of 75 mm Hg on the lymphedema-induced hindlimb for 12 consecutive hours in the first 5 postoperative days (PODs). Group 2 did not receive NPT. Paw thickness measurements and near-infrared laser lymphangiography were measured. Results: The study included 16 mice (group 1 n = 6, group 2 n = 10). Paw thickness on POD 21 in group 1 was 2.9 ± 0.3 mm compared to 3.3 ± 0.3 mm in group 2 (p = 0.02). On POD 35, the average paw thickness was 2.4 ± 0.1 mm in group 1 compared to 3.2 ± 0.2 mm (p = 0.001). Lymphangiography dye clearance was greater in group 1 compared to group 2 (p = 0.008). Conclusions: Mice in the hindlimb lymphedema model that underwent NPT in the early postoperative period had less paw thickness swelling and better lymphatic function than mice that did not have NPT. NPT decreased lymphedema when used prophylactically following lymphatic injury.

This publication has 62 references indexed in Scilit: