Leg Lymphedema Complexity Score (LLCS)

Robyn Bjork of the International Lymphedema & Wound Training Institute (ILWTI), and Heather Hettrick of Nova Southeastern University, have spearheaded an unprecedented initiative to create a Leg Lymphedema Complexity Score (LLCS). Collaborating organizations include the World Alliance for Wound & Lymphedema Care (WAWLC), National Lymphedema Network (NLN), Lymphatic Education & Research Network (LE&RN), Canadian Lymphedema Framework (CLF), American Venous Forum (AVF), American College of Phlebology (ACP), Association for the Advancement of Wound Care (AAWC), International Lymphoedema Framework (ILF) and the Lipedema Foundation. This project is supported by an unrestricted educational grant by SIGVARIS.

This DRAFT of the LLCS tool is focused on the lower extremity and captures 12 domains we commonly encounter with lower extremity lymphedema patients:  Comorbidities, Limb Volume, Edema Texture, Scar Tissue, Skin Integrity, Skin Appearance, Fat Disorders (Lipedema), BMI and Body Shape, Mobility, ADLs, and Pain/Discomfort. We have also incorporated the Lymphedema Life Impact Scale (LLIS), used with permission from author Janet Weiss.  Each domain is rated from 0-4, 0 having no presentation or problem to 4 being the most severe and complex.  Our next steps are two-fold: to better define the score and its clinical meaning and create algorithms of care based on the scores grounded in standards of practice and current evidence.  This should help direct treatment interventions, medical management, tests and measures and referrals.  As we refine and complete the LLCS, we plan to develop an Arm Lymphedema Complexity Score.

The Version 5 (V5) DRAFT of the LLCS tool was released for a broad usability test in clinical practice at the 2017 National Lymphedema Network Conference on Saturday, October 14. We have now completed the final version V10. We invite you to download the Leg Lymphedema Complexity Score (LLCS), and corresponding Lymphedema Life Impact Scale (LLIS), and trial them on ten patients. Note the time it takes to complete the LLCS for each patient, how clinically useful you find the tool, and if there are ways we can improve upon it.

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