title: Conservative management of lymphoedema in children: a systematic review.
abstract: OBJECTIVE
  A systematic literature review was conducted to determine best practice conservative management of pediatric lymphoedema.
  
  
  METHODS
  The PRISMA protocol was followed; a search of Ovid Medline, Cinahl and Scopus was conducted using the search terms children OR pediatric OR adolescent AND lymphoedema OR lymphedema. Studies about management or treatment of lymphoedema in children were included while studies about filariasis, imaging, pathology, secondary lymphoedema, surgical techniques, central lymphoedema and those with participants with a median age greater than 18 years were excluded.
  
  
  RESULTS
  Of 738 possible studies identified, eight studies were eligible for inclusion in the review: four case reports, two retrospective service reviews and two prospective studies investigating different interventions. All studies were rated using the NHMRC hierarchy of evidence and appraised by both authors using the McMaster University Critical Review Form. Studies were of low quality with poor descriptions of management, small sample size, unclear and inconsistent methodology and irreproducible outcome measures.
  
  
  CONCLUSIONS
  This review identified low level evidence to support the use of pneumatic compression in the management of pediatric lymphoedema. Further research is required to identify optimal parameters for application of pneumatic compression and to investigate the use of other interventions for conservative management of pediatric lymphoedema.
authors.affiliation: School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia.
authors.forename: J Jane
authors.initials: JJ
authors.lastname: Phillips
authors.affiliation: School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Gordon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D048228:Intermittent Pneumatic Compression Devices / Q000706:statistics & numerical data*; D008209:Lymphedema / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D012648:Self Care
keywords: Lymphoedema; disease-management; management: self-management; pediatric; therapeutics