The Diagnosis and Treatment of Peripheral Lymphedema: Draft Revision of the 1995 Consensus Document of the International Society of Lymphology Executive Committee for Discussion at the September 3-7, 2001, XVIII International Congress of Lymphology in Genoa, Italy

This proposed revision of the 1995 ISL Consensus Document in the evaluation and management of peripheral lymphedema (1) is based upon modifications su ggested and published following the 1997 XVI International Congress of Lymp hology (ICL) in Madrid, Spain (2), discussed at the 1999 XVII ICL in Chenna i, India (3), and considered at the most recent International Society of Ly mphology (ISL) Executive Committee meeting in Hinterzarten, Germany (4). It is designed to stimulate and frame debate at the upcoming XVIII ICL (Septe mber 2001, Genoa, Italy) and thereby help shape the next official version o f the Consensus Document to be published early next year in the Journal and on the ISL Web site. The document attempts to amalgamate the broad spectru m of protocols advocated worldwide for the diagnosis and treatment of perip heral lymphedema into a coordinated proclamation representing a "Consensus" of the international community. The document is not meant to override indi vidual clinical considerations for problematic patients nor to stifle progr ess. If is also not meant to be a legal formulation from which variations d efine medical malpractice. The Society understands that in some clinics the method of treatment derives from national standards while in others access to medical equipment and supplies is limited and therefore the suggested t reatments are impractical. We continue to struggle to keep the document con cise while balancing the need for depth and details. With these considerati ons in mind, we believe that the next version of the Consensus should repre sent the best judgment of the ISL membership on how to approach patients wi th peripheral lymphedema as of 2001. We anticipate that the document will a nd should be challenged, debated in the pages of Lymphology (e.g., as Lette rs to the Editor), and ideally become a continued focal point for robust di scussion at local, national and international conferences in lymphology and related disciplines. We further anticipate as experience evolves and new i deas and technologies emerge that this "living document" will undergo perio dic revision and refinement.