Diagnosis and Treatment of Axillary Web Syndrome:An Overview

摘要

Axillary web syndrome(AWS)is a self-limiting disease that can occur as an early or possibly late postoperative complication post-axillary surgery.This syndrome is characterized by the spread of the cords of subcutaneous tissue extending from the axilla into the arm and is clinically associated with pain and limited movement of the shoulder in the affected limb.Although its pathophysiology is not well established,the most common cause is surgery-related axillary lymphatic injury.Both the echography and magnetic resonance imaging results support the lymphatic hypothesis.The diagnosis of AWS is based on physical examination.Risk factors may include extensiveness of surgery,younger age,hypertension,lower body mass index,ethnicity,and healing complications.Effective clinical intervention shortens the natural course of AWS and improves the quality of life of patients with AWS.Treatments may include physical therapy,drug therapy,manual drainage,instrument-assisted soft tissue mobilization(IASTM),thoracic manipulation and stretching,manual axial distraction,percutaneous needle cord disruption with fat grafting and Xiaflex injection,and surgical intervention.Routine surgical treatment for AWS may not be recommended.Further research is needed to provide more comprehensive improvements in the diagnosis and treatment of AWS.