Phlebolymphedema
is a unique condition of combined insufficiency of both the
venous and lymphatic systems. There is a very close relationship between
the venous and lymphatic systems; therefore a venous obstruction may
develop a phlebo-lymphedema. Here we find a failure in the dual
outflow system, and although being totally different hemodynamic
mechanisms, they are mutually dependant and complementary circulation
systems. Due to their intimately integrated function, failure in one
system means then additional burden and overload of the other.
There
are various causes: Primary Phlebolymphedema and Secondary
Phlebolymphedema
Primary
Phlebolymphedema is caused by a congenital defect, involving an
outset of diffused trancular lymphatic malformation, affecting both
the venous and lymphatic systems. Primary Phlebolymphedema is still a
relatively unknown condition and in the majority of cases represents
the clinical manifestation of Klippel –Trenaunay Syndrome. The
presence of an arteriovenous malformation makes the overall condition
of Primary Phlebolymphedema much harder to manage. It is also thought
that Long-term strain on the lymphatic system can be a cause of
phlebo-lymphedema
Secondary
Phlebolymphedema is an acquired condition that starts off with
chronic Venus insufficiency due to various causes, and which later
leads to chronic lymphatic insufficiency. In
the presence of venous hypertension, which is characteristic of most
venous disorders, the increase in lymphatic flow becomes much greater
than the lymph transport capacity. Treatment for chronic Secondary
Phlebolymphedema consists of treating the venous abnormality and
watching regression of the lymphatic problem.
The
diagnosis of Primary and Secondary Phlebolymphedema is based on a
detailed history and physical examination, and related tests.
The
majority of patients with phlebolymphedema will require a course of
Complete
Decongestive Therapy (CDT).
CDT consists of an acute phase to reduce the lymphedema, followed by
a lifelong maintenance phase to prevent a recurrence. Treatments
consist of Manual
Lymph
Drainage
(MLD), skincare, exercise, and Compression
Bandaging
with short-stretch compression bandages. It is recommended that
treatment be performed by a certified lymphedema physiotherapist.
Read
more about what
is the best treatment option for lymphedema HERE.
Patients should be specially careful when choosing a lymphedema Multidisciplinary Expert Centre of Reference/Excellence, as not all centers and counties offer or provide the same treatment options. The best choice is the Expert Reference Centre of Excellence that applies Complete Decongestive Therapy (CDT), which is recognized as the "Gold Standard" treatment for Lymphedema. Read more about the components that form part of the Conservative Treatment in the German Scientific Protocol HERE.
Information
source and references:
- Phlebolymphedema–ACommon Underdiagnosed and Undertreated Problem in the Wound CareClinic
- Phlebolymphemeda:usually unrecognized, often poorly treated
- Phlebolymphedema:is it a new concept?
- Phlebolymphedemais the ultimate comorbidity/outcome of lymphedema
- Phlebolymphedema:Disregarded cause of immunocompromised district
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