International 
                                            Consensus Document
      Lipoedema: a paradigm shift 
      and consensus
        SUPPORTED BY
                          Authors:                                                             Christine Moff att: Nottingham Trent University, UK
                          Lead authors: Tobias Bertsch, Gabriele Erbacher                      Nestor Torio-Padron: Practice Clinic for Plastic Surgery, 
                                                                                               Freiburg, Germany
                          Földi Clinic, Hinterzarten–European Center of Lymphology,            Christian Ure: Lymphology Clinic, Wolfsberg, Austria
                          Germany
                          Author: Rebecca Elwell                                               Stephan Wagner: RehaClinic, Bad Zurzach, Switzerland
                          University Hospitals of North Midlands NHS Trust, UK                 Other KOLs supporting the consensus
                          Foreword written by: Hugo Partsch                                    Hakan Brorson: Department of Clinical Sciences, Lund 
                          Division of General Dermatology, Medical University of Vienna,       University, Plastic and Reconstructive Surgery, Skåne University 
                          Austria                                                              Hospital, Malmö, Sweden
                          Consensus group                                                      Leif Perbeck: Karolinska University Hospital, Sweden
                          Tobias Bertsch, Gabriele Erbacher,   omas Zähringer: Földi          Nele Devoogdt: Department of Rehabilitation Sciences, 
                          Clinic, Hinterzarten–European Center of Lymphology, Germany          Katholieke Universiteit Leuven, Belgium
                          Domenico Corda: Polimedica San Lanfranco, Pavia, Italy               Sarah   omis: University Hospitals Leuven, Belgium
                          Robert J. Damstra, Kirsten van Duinen, Jose van Esch-Smeenge,        Stéphane Vignes: Lymphology Service, Reference Centre for 
                          Ad Hendrickx, Bea Koet: Center of Expertise in Lymphovascular        Rare Vascular Diseases, Hôpital Cognacq-Jay, Paris, France
                          Medicine, Nij Smellinghe, Drachten,   e Netherlands                 Michael Oberlin: Földi Clinic–European Center of Lymphology, 
                          Joanna Dudek: SWPS University of Social Sciences and                 Hinterzarten, Germany
                          Humanties, Warsaw, Poland                                            René Hägerling: Researcher at Charité, University of Berlin, 
                          Rebecca Elwell: University Hospitals of North Midlands NHS           Germany
                          Trust, UK                                                            Katja S. Mühlberg: University of Leipzig, Germany
                          Gabriele Faerber: Centre for Vascular Medicine, Hamburg,             Erika Mendoza: Practice for Venous Diseases, Wunstorf, 
                          Germany                                                              Gemany
                          Sharie Fetzer: Lipoedema UK, UK                                      Andrzej Szuba: Department of Angiology, Hypertension and 
                          Jodok Fink: Department of General and Visceral Surgery at the        Diabetology, Wroclaw Medical University, Poland
                          Medical Center, University of Freiburg, Germany
                          Annemarieke Fleming: Rehabilitation-Centre Reade,                    Acknowledgements:   anks to the staff  of the Földi Clinic for 
                          Amsterdam,   e Netherlands                                          the personal and professional support provided in writing this 
                          Kristiana Gordon: St. George’s Hospital, UK                          supplement as well as the articles it is based on.   e authors 
                                                                                               are also grateful to the medical directors Prof. E. Földi and Dr 
                          Denise Hardy: Kendal Lymphology Centre, UK                           M. Földi and senior consultants Dr K.-P. Martin, Dr U. Walz-
                          Tobias Hirsch: Practice for Internal Medicine and Vascular           Eschenlohr and Dr M. Oberlin. Further, special thanks are due to 
                          Disease, Halle, Germany                                              Dr Kevin Sander and Essity for helping to organise the European 
                          Peter Mallinger: Klagenfurt Clinic, Austria                          Lipoedema Forum. Lastly, the authors thank Rucha Kurtkoti, 
                                                                                               Editor of the British Journal of Community Nursing, for editorial 
                          Anya Miller: Practice for Dermatology, Berlin, Germany               and publication support.
                       This supplement is supported by: Jobst and Medi
                       Editor: Rucha Kurtkoti
                       Project manager: Camila Fronzo
                       Design: Fonthill Creative
                       Managing director: Anthony Kerr, anthony.kerr@markallengroup.com
                       Published by: MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London, SE24 0PB, UK
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                       2                          JOURNAL OF WOUND CARE CONSENSUS DOCUMENT VOL 29, SUP. 2, NO 11, NOVEMBER 2020
                       22
                                                                                  Contents
                1. Foreword                                                                                   5
                2. The paradigm shift: there is no oedema in lipoedema                                        6
                Conclusion                                                                                   10
                3. Myth: Lipoedema maes patients fat                                                         11
                Conclusion                                                                                   12
                . Myth: eight loss has no effect on lipoedema                                              13
                Conclusion                                                                                   17
                . Myth: Lipoedema is a progressie disease                                                  18
                Conclusion                                                                                   20
                . Myth: Lipoedema causes mental health disorders                                            21
                Conclusion                                                                                   22
                 . Myth: Liposuction is effectie for lipoedema­ producing
                long€lasting results                                                                         23
                Conclusion                                                                                   29
                ‚. ƒeriew of „uropean …est practice consensus on lipoedema                                 30
                The paradigm shift                                                                           30
                JOURNAL OF WOUND CARE CONSENSUS DOCUMENT VOL 29, SUP. 2, NO 11, NOVEMBER 2020                   333
             Contents
             †athophysiological model of lipoedema                                    31
             Consensus on the scientifi c …acground of and diagnostic 
             approach for lipoedema                                                  32
             Consensus on the treatment of lipoedema                                 34
             ˆ. ‰enaming the term ‘lipoedema’                                        44
             1Œ. Final remars                                                       45
             ‰eferences                                                              46
             'The great enemy of truth is very often not the lie—deliberate, contrived and dishonest—but the 
             myth—persistent, persuasive and unrealistic. Too often we hold fast to the cliches of our forebears. We 
             subject all facts to a prefabricated set of interpretations. We enjoy the comfort of opinion without the 
             discomfort of thought.'
             John F Kennedy, commencement address at Yale University, 11 June 1962
             44             JOURNAL OF WOUND CARE CONSENSUS DOCUMENT VOL 29, SUP. 2, NO 11, NOVEMBER 2020