martes, 4 de febrero de 2014

WHAT IS PHLEBOLYMPHEDEMA - Pediatric and Primary Lymphedema - Secondary Lymphedema - Lymphostatic Elephantiasis



Phlebolymphedema is a unique condition resulting from the combination of circulatory insufficiency of two systems, both venous and lymphaticThere 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 they have totally different hemodynamic mechanisms, they are mutually dependent 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 venous 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 the regression of the lymphatic problem.


The diagnosis of primary and secondary phlebolymphedema is based on a detailed patient 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 lymphedema, followed by a lifelong maintenance phase to prevent a recurrence. Treatments consist of Manual Lymph Drainage (MLD), skin care, exercise, and Compression Bandaging with short-stretch compression bandages. It is recommended that treatment be performed by a certified lymphedema physiotherapist


IMPORTANT NOTICE 

Lymphedema is a serious chronic and progressive disease due to lymphatic dysfunction ( Organic Lymphatic Vascular Disease). The clinical treatment of lymphedema is neither a cosmetic nor an aesthetic treatment. The treatment of lymphedema is to control its progression and alleviate the symptoms related to dysfunction of the lymphatic circulatory system. 

To prevent and avoid serious complications associated with treatment, such as the possible displacement of edema to previously unaffected areas when compression therapy is applied for volume reduction, patients should use highly specialized and experienced therapists. 

Professional qualification and instruction delivered remotely online are not the same as live hands-on practical instruction in the clinical training and certification of lymphedema therapists, similar to all other rehabilitation, medical, and surgical training programs, and especially for developing the necessary manual skills to treat a disease as complex as lymphedema. 

Patients should also take special care when choosing a Multidisciplinary Expert Center of Reference for Lymphedema, as not all countries and centers provide the same treatment options. The best choice is a center of reference that provides Complete Decongestive Therapy (CDT), which is recognized as the “Gold Standard” treatment for lymphedema.

  • Read more about what is the best treatment option for Lymphedema HERE.
  • Read about what are the principal functions of Manual Lymphatic Drainage HERE.
  • Read about what are the main differences between the two principal lymphedema treatment protocols HERE.
  • Read about what are the strategies for the implementation of low-cost treatment options for Lymphedema HERE 


REFERENCES

(Click on the texts to read the research articles)

SCIENTIFIC SOCIETIES

PATHOPHYSIOLOGY

CUTANEOUS COMPLICATIONS
INFECTIOUS COMPLICATIONS
CELLULITIS / DERMATOLYMPHANGIOADENITIS
TUMOURS

TREATMENT

COMPRESSION GARMENTS

DISABILITY

DISFIGUREMENT

PSYCHOSOCIAL IMPACT

PEDIATRIC LYMPHEDEMA

LYMPHATIC FILARIASIS / PODOCONIOSIS








  • WHAT KIND OF DOCTOR TREATS LYMPHEDEMA/LYMPHOEDEMA - WHICH MEDICAL SPECIALITIES ARE RELATED TO LYMPHEDEMA











LYMPHEDEMA INCIDENCE 
AND PREVALENCE
(click on the texts) 









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