This case report describes a rare and clinically highly complex constellation of massive scrotal elephantiasis, generalized lymphedema, and septic deterioration, which initially raised the suspicion of a malignant soft tissue tumor. The report highlights the diagnostic pitfalls associated with extreme scrotal enlargement, the nuanced decision-making regarding timing and extent of surgical intervention in a persistent septic setting, and the urological, pathological, and reconstructive implications of radical resection under extraordinary anatomical conditions. Reports of scrotal elephantiasis presenting as a primary septic focus in non-endemic regions remain rare and are largely limited to isolated case descriptions. This case illustrates clinically relevant diagnostic and therapeutic decision-making in the management of this unusual constellation.

Aim: To verify the evidence of content validity of the nursing diagnosis "Ineffective Lymphedema Self-Management" in women who underwent mastectomy. Design: Methodological study of content validation by expert judges. Method: Content validation was conducted between July and October 2023 through a semi-structured online questionnaire sent to 80 expert judges, of whom 52 participated. The study was approved by the Research Ethics Committee (CAAE No. 63063922.0.0000.5078). Elements identified in a preceding concept analysis were evaluated for relevance using Aiken's V coefficient (V ≥ 0.90) with 95% confidence intervals. Cronbach's alpha was used to assess internal consistency. The sample size (n = 47) was determined using a precision estimation formula for content validity indices. Results: Of the 47 terms submitted for evaluation, 31 were considered valid as defining characteristics and related factors. The terms "psychological and cognitive limitations" and "patients who underwent a mastectomy" were validated for associated conditions and at-risk population, respectively. Expert judges suggested the inclusion of "female breast cancer survivors," "access to health services," and "lack of medical information." Cronbach's alpha was 0.97 (95% CI: 0.96-0.98). Conclusion: The nursing diagnosis "Ineffective Lymphedema Self-Management" was partially validated. New elements were identified that may elevate the evidence level of this diagnosis and refine its applicability in clinical practice. Implications for Nursing Practice: The validated elements provide nurses with a structured framework for identifying and managing lymphedema in women who underwent mastectomy, contributing to early detection and targeted interventions.

Recurrent cellulitis causes substantial morbidity, healthcare use, and repeated antibiotic exposure. Chronic oedema is a key modifiable risk factor for incident and recurrent cellulitis, yet preventive strategies targeting oedema remain underused. Our randomised controlled trial previously demonstrated that compression therapy reduced cellulitis recurrence, leading to early trial cessation for efficacy at interim analysis. We report extended follow-up outcomes.

Background/Objectives: Compression therapy serves as first-line conservative management for low-flow vascular malformations and Klippel-Trénaunay syndrome (KTS). However, ready-made garments are frequently ill-fitting for patients with limb overgrowth, asymmetry, deformity, or heterogeneous body habitus. Custom-made compression elastic garments offer an individualized solution, yet systematic data across diverse clinical entities remain scarce. This study evaluated objective and subjective outcomes of custom-made compression garments across vascular anomalies and edematous disorders in a multi-institutional real-world setting. Methods: A retrospective observational case series was conducted between May 2023 and September 2025 at four institutions: a tertiary medical center, a pediatric specialty hospital, a corporate hospital, and a corporate clinic. Patients who received custom-made compression elastic garments for vascular anomalies, edema, varicose veins, post-traumatic or post-burn venous stasis, or postoperative conditions were included. Objective outcome (limb circumference change) and subjective outcome (patient satisfaction) were analyzed. Results: A total of 191 patients who received custom-made garments were described (117 females, 61.3%; 74 males, 38.7%; mean age 36.3 years; median 22 years; range 1-96 years). The age distribution was bimodal, with 91 patients (47.6%) aged 0-19 years and 50 patients (26.2%) aged ≥70 years. The tertiary center and pediatric hospital treated vascular anomaly patients exclusively (n = 102), while the corporate hospital and clinic primarily served adult and elderly edematous disorder patients (n = 88; one additional vascular anomaly case was managed at the corporate hospital). Quantitative paired outcome analysis was feasible in the subgroups with complete paired data: 20 vascular anomaly patients (objective outcome) and 20 edematous disorder patients (subjective outcome). In the vascular anomaly subgroup (n = 20), the affected limb showed a significantly greater circumference reduction at the ankle's narrowest point (median -2 mm, IQR -4.2 to 0.0) compared with the unaffected contralateral limb (median +0.5 mm, IQR -0.2 to +1.0; Wilcoxon signed-rank test T = 4; p < 0.001; effect size r = 0.83). In the edematous disorder subgroup (n = 20), patient satisfaction scores improved significantly from a median of 3 (IQR 2.0-4.0) to 4 (IQR 3.0-6.0) after garment use (Wilcoxon signed-rank test T = 0; p < 0.001; effect size r = 0.83). Representative cases illustrated pediatric vascular anomaly (Case A, vascular malformation; Case C, KTS) and adult edematous disorder (Case B, chronic lower limb edema) presentations and outcomes. Conclusions: Custom-made compression elastic garments were feasible and well tolerated across a broad real-world spectrum of vascular anomalies and edematous disorders. In the analyzed subgroups, a measurable reduction in affected-limb circumference was observed in pediatric vascular anomaly patients, and patient satisfaction improved in adult and elderly edematous disorder patients. Because each subgroup was evaluated with only one outcome domain and no head-to-head comparison of measures was performed, these findings should be regarded as hypothesis-generating. We propose that outcome measures may need to be tailored to disease background and age, a hypothesis that warrants testing in prospective studies capturing both objective and subjective endpoints across all patient groups.