ILF 2025: The 12th Interna1onal Lymphoedema Framework Conference
Building Bridges: Connec1ng Global Perspec1ves
The 12th Interna,onal Lymphoedema Framework Conference, Building Bridges: Connec,ng Global Perspec,ves, took place in the Sheraton Fallsview Hotel, Niagara Falls, Ontario, Canada in October 2025.
ILF Frameworks day: 22 October
The Interna,onal Lymphoedema Framework (ILF) Frameworks day was held the day before the conference started. A total of 42 members took part, represen,ng 18 different frameworks. The day began with welcomes to all, and with Chris,ne MoffaS introducing Arthur Bagonza as the new Execu,ve Director of the ILF. Chris,ne will con,nue her involvement becoming Life,me President.
Next came a spotlight on the different frameworks, with updates about ongoing work and the challenges they faced in their country from all present. Chris,ne emphasised that the ILF strategy wasn’t about growing the number of frameworks but responding to people asking to join as a framework. The criteria for developing a framework are about respect for professions to work together, for pa,ents to be integral and to work with medical partners.
Arthur Bagonza then outlined the 10-year strategy plan, which comprises five pillars:
1. Research
2. Communica,on
3. Educa,on
4. Advocacy
5. Service development (with lessons learned from frameworks)
He also discussed the strengths of the ILF and the challenges it faces going forward. The plan is to have a comprehensive consulta,on strategy by the end of the year and then have in-depth discussions to agree the plan for the next 10 years.
In the a^ernoon, aSendees broke out into groups to discuss and feedback on the following areas: how to improve compression worldwide; what the ILF should focus on in educa,on; what outcome measures should be considered; and how can we take the children’s strategy forward. The outcomes of these discussions will inform the work of the ILF in future
Opening day of conference: 23 October
The first day of the conference began with a masterclass from Chris,ne MoffaS, talking about the preven,on, recogni,on, and response to celluli,s in lymphedema, and the role of infec,on control. The
main opening then took place with a warm welcome from Chris,ne MoffaS and Arthur Bagonza to the 600 delegates present, along with thanks to the exhibitors for suppor,ng the conference and to the Canadian Lymphedema Framework and the Interna,onal Lipoedema Associa,on for organising such an engaging and diverse programme
The opening keynote speech, from Professor Wei Chen of the Cleveland Clinic, discussed whether supermicrosurgical treatment of Alzheimer's disease, aka brain lymphedema, is a clinical reality. He discussed the theory that Alzheimer’s disease can be considered to be lymphedema of the brain. In the brain lympha,cs are called the glympha,c system and Professor Chen outlined its role in ‘rinsing away cellular waste’ around the neurons during sleep. He then talked about lympha,cvenular anastomosis, a microsurgical technique that connects ,ny lympha,c vessels in the brain to blood vessels. This was first tested in China, and the team from Cleveland have been trialling this in currently unpublished studies. This talk was followed by the first set of parallel sessions, covering everything from funding for lymphedema care to surgical planning and the role of gene,cs
During the break sessions, delegates were able to try out the skills zones in the exhibi,on area, giving them the opportunity to enhance their clinical exper,se. There were three skills zones: Rethinking deconges,on: empowering pa,ent self-care by Haddenham; Every step counts – advancing compression knowledge by Medi; and Wrap with confidence: hands-on compression techniques for lymphedema management by Solventum. These 25-minute prac,cal sessions focused on key aspects of lymphoedema care and management, offering hands-on learning guided by industry professionals and delivering focused, realworld insights that can be applied in prac,ce. A^er this break, the second set of parallel sessions covered topics ranging from a mentor–mentee panel, to Canadian prevalence data and the poten,al of a subjec,ve health experience model for advancing personalised care for people with lymphedema or lipedema.
The first lunch,me symposium sponsored by Thuasne discussed compression garments in lymphedema management: from mode of ac,on to clinical evidence in the maintenance phase Dr Valérie Tauveron outlined the mechanisms behind limb volume reduc,on and skin improvements observed in pa,ents using Mobiderm® Autofit, and Professor Isabelle Quéré presented new clinical data from the LYMPHONIGHT study, highligh,ng the effec,veness of Mobiderm® Autofit night-,me compression in managing upper limb lymphedema during the maintenance phase. The a^ernoon’s parallel sessions covered topics ranging from whether lymphedema is a systemic disease, to long-term survivorship and pa,ent-centred insights in breast cancer–related lymphedema, to a series of oral abstracts looking at mul,disciplinary care and ,ssue evalua,on in lipedema.
The first day of the conference closed with a keynote speech from Dr David Doubblestein, Associate Professor at A.T. S,ll University. He talked about the care of breast cancer-related lymphedema, highligh,ng the importance of measuring what truly maSers for pa,ents, and encouraged delegates to have faith in their clinical reasoning. He emphasised that everyone caring for pa,ents with breast cancer-related lymphedema should dis,nguish evidence-based interven,ons from outdated or unsupported guidance, par,cularly when these are based on common clinical beliefs, and discussed the need to implement a standardised core outcome set for these pa,ents. He concluded by talking about strategies that can be used to integrate clinical reasoning, pa,ent priori,es, and research evidence to improve care for people
living with breast cancer-related lymphedema. Delegates and exhibitors then aSended a welcome recep,on which was kindly sponsored by Sigvaris.
Day 2: 23 October
The pa,ent conference began today, with over 70 pa,ents joining the conference Professor Kris,ana Gordon from St George’s Hospital, London, gave the masterclass on the classifica,on of primary lymphoedema. She highlighted that there are at least 2000 different types of primary lymphedema which vary in terms of age and onset. As different gene,c problems present with different symptoms, accurate diagnosis is vital to allow signpos,ng to the correct departments for further treatment. She talked about the assessment done in the primary lymphedema clinic and then took aSendees through the St George’s classifica,on algorithm, explaining how this can be used both for diagnosis but also for seeing how primary lymphedema may present if a gene,c muta,on is found on screening. The ques,ons she suggested asking when classifying primary lymphedema are: When did it develop? Are there any other sites affected? Are there any other health problems? Does the pa,ent look dysmorphic? Is there a family history? and she then illustrated how these apply to a number of cases to allow accurate diagnosis and treatment.
Friday morning ’s keynote presenta,on was given by Dr Stanley Rockson discussing the research done by him and his team at Stanford to try and find a drug to reverse and prevent lymphedema. They have used a mouse model to create and inves,gate pathways in lymphedema, with the tail ac,ng as a surrogate for the arm or leg. In early studies, changes in gene,cs were linked to inflammatory responses and immune func,on, indica,ng that the biology of lymphedema is the biology of inflamma,on. This led to a series of studies using ketoprofen, a non-steroidal an,-inflammatory drug, which showed a drama,c improvement in the histological appearance of skin in treated pa,ents, but ketoprofen was withdrawn for long-term use by the Food and Drug Administra,on as it has long-term cardiovascular issues. The team showed that any drug that inhibited leukotriene B4 was effec,ve, which has led to further studies. The phase 2 HEAL trial (NCT05203835) tested acebilustat (an orally bioavailable small molecule inhibitor of leukotriene A4 hydrolase) vs placebo to measure the effect on lymphedema of the arm and is hoping to report in the first quarter of 2026. Acebilustat is now included in an expanded access programme (use of inves,ga,onal drug in clinical prac,ce) for lower limb, non-cancer-related lymphoedema, and in a similar programme for pa,ents with lipedema, which is showing promising results.
The first set of parallel sessions on Friday included pa,ent-focussed sessions on movement to meaning: suppor,ng daily ac,vity while living with lymphedema and the importance and challenges of compression bandages, wraps and garments in lymphoedema, alongside clinical sessions on the challenges of lymphedema care in low resource sepngs and a range of oral abstracts. In the second set of parallel sessions, an interac,ve panel discussion considered real-world strategies for assembling and sustaining mul,disciplinary research teams in lymphedema, alongside an overview of evidence-based guidelines in lymphedema, wound preven,on, and healing, giving some interdisciplinary insights into the area.
Friday’s lunch,me symposium, sponsored by JOBST, looked at the interplay between obesity, lymphedema, and lipedema syndrome – from challenge to ac,on. Anna Towers set the stage with a Canadian perspec,ve on obesity and its impact on lymphedema, including breast cancer-related lymphedema and diagnos,c
criteria for lipedema-syndrome. Then Tobias Bertsch and Guenter Klose explored the role of obesity in lipedema-syndrome and approaches to treatment covering everything from compression therapy and movement to the psychosocial dimensions of weight and surgical considera,ons. The a^ernoon’s parallel sessions included a look at children and young people with lymphedema, global struggles in improving access to lymphedema care and pa,ent sessions on the poten,al place of GLP-1 inhibitors in lymphedema care and a pa,ent-centred approach for priori,sa,on of future lymphedema care
The closing keynote on Friday was a fascina,ng look at the clinical management and outcomes of the toughest lymphedema cases, by Professor Kris,ana Gordon. She highlighted a number of cases including one of celluli,s and lymphedema, emphasising that 5 days of an,bio,cs isn’t enough and recommended that pa,ents should take an,bio,c prophylaxis if they experience two or more infec,ons/year. She outlined a case of obesity-related lymphedema and flagged up that intensive treatment is fu,le if the obesity is not treated. Professor Gordon stated that GLP-1 (glucagon-like pep,de-1) agonists make a big difference to these pa,ents and is excited to see the results of research into using GLP-1 agonists to treat lymphedema. She presented a case of facial lymphedema caused by rosacea as this affects the lympha,c system, and talked about lymphedema gastroenterology where she discussed a case linked to Crohn’s disease of the genital ,ssue. She emphasised the importance of mul,disciplinary working in these cases, such as linking in with gastroenterology colleagues. The day closed with a welcome recep,on to celebrate the first day of the pa,ent conference.
Day 3: 24 October
The final masterclass of the 12th ILF conference looked at managing wound infec,ons from biofilm to best prac,ce, given by Dr David Keast, Medical Director of the Chronic Wound and Lymphedema Consulta,on Clinic, Parkwood Ins,tute, London, Canada. He highlighted that chronic wounds present a complex and costly challenge, and that effec,ve management hinges on early iden,fica,on of infec,on and a comprehensive approach to wound bed prepara,on. Dr Keast outlined the importance of developing a plan of care that involves debridement, managing the infec,on and controlling the exudate, with the pa,ent at the centre of the plan, and emphasised that debridement may not be needed at every dressing change, while exudate should be controlled by managing the underlying cause and selec,ng an appropriate dressing. He drew on the 2022 consensus document on wound infec,on in clinical prac,ce and the 2025 therapeu,c wound and skin cleansing recommenda,ons, both from the Interna,onal Wound Infec,on Ins,tute. Key takeaways included the importance of being alert for clinical indicators of poten,al biofilm and ini,a,ng biofilm-based wound care when appropriate using a step-down/step up approach, and that good nutri,on is vital for wound healing.
Saturday’s final keynote speech was an inspira,onal talk by Heather Ferguson, founder and execu,ve director of the Lymphedema Advocacy Group, an American organisa,on of pa,ents, caregivers, healthcare professionals and industry partners. Their aim is to advance lymphedema care in the United States by advoca,ng for improved access to care and for diagnosis and treatment of the disease. One of Heather’s twin sons was diagnosed with primary lymphedema at 7 months of age, and compression garments were prescribed for him. The family’s insurance provider ini,ally declined to provide this but finally agreed to cover them for 1 year and then reconsider the case. At this point, Heather made it her mission to make
sure he had insurance coverage for compression supplies. This is not covered by Medicare, which tends to be the criteria used by other providers. In 2010 Heather’s congressional representa,ve introduced the Lymphedema Treatment Act, but it took un,l 2019 for the act to be passed by the House of Representa,ves, and in 2022 it passed the Senate and the House to become law in the USA. Heather emphasised that the most important thing for advocacy is tools – emails, phone numbers, call scripts, tools for advoca,ng on social media, and for sending leSers to newspapers and media outlets. The Lymphedema Advocacy Group now plans to get lymphedema the same recogni,on as any other chronic disease, ensure that insurance plans comply with new rules, get other plans to cover this, address reimbursement issues, and make sure pa,ents, providers and suppliers are aware of this new coverage.
Saturday’s first set of parallel sessions contained a number of oral abstract presenta,ons, looking at transla,ng knowledge into prac,ce: global perspec,ves in lymphedema, innova,ons in breast cancerrelated lymphedema diagnosis and management, and novel therapies and implementa,on strategies in lymphedema The next session included the official launch of a new interna,onal resource on the management of chronic oedema in the lower leg, jointly developed by the European Wound Management Associa,on (EWMA) and the Interna,onal Lymphoedema Framework (ILF). The document expands on exis,ng treatment principles by reflec,ng the clinical reali,es across different countries. It provides clear recommenda,ons for accurate diagnosis, effec,ve treatment – including compression therapy – and longterm management. What makes this resource unique is not only its clinical guidance but also its inclusion of pa,ent perspec,ves, prac,cal pathways, and global applicability. Building on the success of the 2023 EWMA document Lower Leg Ulcer Diagnosis and Principles of Treatment, this new publica,on offers a comprehensive approach designed to improve pa,ent care worldwide.
The lunch,me symposium, sponsored by Medi, focussed on making compression happen. Els Brouwer introduced COMPAS – the Compression Asia-Pacific (APAC) Summit and the future of compression therapy in this region and Europe. Dr Arthur Bagonza then talked about the experience of building regional lymphedema care pathways in the APAC-region from a mul,stakeholder perspec,ve. Finally, Dr Chris,an Taeger detailed the mul,disciplinary approach to the management of lymphedema, providing insight into the treatment methods at each stage of disease progression, from super-microsurgery to liposuc,on. In the final set of parallel sessions, delegates learned about the development of a nutri,onal programme that focuses on the emerging role of sarcopenic obesity in the management of lymphoedema - a condi,on increasingly recognised for its impact on pa,ent outcomes while the final pa,ent sessions looked at psychosocial aspects of living with a chronic disease like lymphedema, and understanding surgery for lymphedema. The closing ceremony honoured outstanding contribu,ons, reflected on the highlights of an inspiring three days, and offered a look at what’s ahead for the ILF