Assessment of the Efficacy of the Dynamic Decongestive System in the Intensive Phase of Lower Limb Lymphedema

Background Lymphedema is a chronic, incurable swelling of the limbs that requires aninitial intensive decongestive phase followed by lifelong maintenance based mainly oncompression. Properly delivered, this two phase approach can significantly reduce limbvolume, lower infection risk, and improve quality of life, but the condition remainsunder recognized, stigmatizing, and costly for patients and health systems.Lymphedema markedly impairs daily function, mobility, body image, and mental health, andis associated with anxiety, depression, sexual dysfunction, social isolation, and worklimitations. In Europe, most secondary lymphedema cases arise after cancer surgery andadjuvant therapies, particularly for breast, gynecologic, gastrointestinal, melanoma, andprostate cancers, with an increasing burden of lower limb disease linked in part toimproved cancer survival and the diffusion of robotic surgery.Management guidelines (e.g., HAS, ISL) recommend multidisciplinary care and intensivedecongestive treatment (IDT) when excess volume is significant, followed by maintenance.IDT typically combines daily multi component bandaging (MCB), exercise, skin care, andmanual lymphatic drainage, the latter mainly for comfort and adherence rather than provendecongestive efficacy. A key goal is maximum volume reduction, which drives functional,preventive, and psychological benefits and prepares patients for the long maintenancephase. MCBs remain the cornerstone of physical decongestion. However, they requirefrequent tightening as volume decreases, involve complex, time consuming multilayerapplication with substantial material costs, and are highly operator dependent.They also motivate the search for improved compression technologies‐especially dynamicsystems that are quick and easy to apply, less operator dependent, to optimizedecongestion, support long term self management, and reduce overall costs.