A key to understanding postoperative lymphoedema: a study on the evolutionand consistency of oedema of the arm using ultrasound imaging

Post-mastectomy oedema is a very serious complication that, in the course o f time, will transform into fibrotic tissue. The aim of our study is to eva luate when and in which layer liquid oedema transforms into fibrotic tissue . To do so, ultrasonographic images were taken of 22 patients and 9 control women at the shoulder and 10 cm proximal and distal from the olecranon, wi th the images then being scanned and imported into a computer program to de termine echogenicity of the dermis, subcutis, subcutis on dermal side and s ubcutis on fascial side. Statistical analyses were performed by means of th e Wilcoxon test and a Student's t-test. No significant differences (P less than or equal to0.05) were found for the different parameters in the contro l group. In the experimental group: significant differences in perimeter, s kinfold, thickness of dermis and subcutis were found. Although not signific ant, subcutaneous tissue was more echogenic on the oedematous side, with si gnificant hyperechogenicity at the fascial subcutaneous layer. This indicat es that fibrotic tissue develops distally in the forearm. (C) 2001 Harcourt Publishers Ltd.