ILWTI and Nova Southeastern University have spearheaded an unprecedented initiative to create a standardized Lower Extremity Lymphedema Severity Score (LE LSS). 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 a specialist representing the Lipedema interest. This project is supported by a $10,000 unrestricted educational grant by SIGVARIS.
This DRAFT of the LSS 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, Pain/Discomfort, and we have 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. The scores are then grouped according to severity ranging from minimal severity (0-9), mild severity (10-22), moderate severity (23-35) and max severity (36-48). 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 LE LSS, we plan to develop the Upper Extremity Lymphedema Severity Score, UE LSS.
The V5 DRAFT of the LE LSS tool was released for a broad usability test in clinical practice at the 2017 National Lymphedema Network Conference on Saturday, October 14. We invite you to download the Lower Extremity Lymphedema Severity Score (LE LSS) and corresponding Lymphedema Life Impact Scale (LLIS) and trial them on ten patients. Note the time it takes to complete the LE LSS for each patient, how clinically useful you find the tool, and if there are ways we can improve upon it. Then, click the button below to complete a brief on-line survey, and submit your LE LSS scores for up to ten patients.