Pilot Study: Postoperative Evaluation of Upper Extremity Lymphedema Using a Cutometer: A Single-center Prospective Observational Study

Background: Owing to the presence of congested lymphatic fluid, lymphedema involves greater stiffness than other types of edema. Although lymphaticovenular anastomosis relieves the symptoms of lymphedema, the resulting skin stiffness remains to be objectively evaluated. Therefore, in this study, we aimed to explore the objective indicators of lymphaticovenular anastomosis outcomes. Methods: Eleven female patients with unilateral secondary upper extremity lymphedema who underwent lymphaticovenular anastomosis were divided into “improved” and “unchanged” groups based on the subjective perception of their symptoms after surgery. Skin stiffness and viscoelasticity were measured using a Cutometer. In this study, “skin stiffness” was defined as the maximum deformation under negative pressure, whereas “viscoelasticity” represented the ratio of delayed to immediate deformation, reflecting time-dependent tissue recovery. Results: Skin viscoelasticity on the affected side differed significantly between the 2 groups, with the improved group exhibiting higher values than the unchanged group. In addition, there was a significant difference between the healthy and affected sides in the unchanged group. Conclusions: Skin viscoelasticity could be a useful objective indicator of lymphaticovenular anastomosis outcomes and could help monitor lymphedema progression. Moreover, the use of a Cutometer could improve the objectivity of lymphedema assessments, thereby enhancing patient care and postoperative evaluations.