domingo, 15 de julio de 2018

WHAT IS THE BEST TREATMENT OPTION FOR LYMPHEDEMA - State of the art lymphedema management - Choosing a Lymphedema Expert Reference/Excellence Centre

The best first option treatment for lymphedema, regarded as Gold Standard Treatment by the International Society of Lymphology (ISL), is known as Complex Decongestive Therapy (CDT). This conservative and specialized physiotherapist treatment is highly effective and has been used for decades, with little or no side effects for the reduction and maintenance of lymphedema.

The conservative treatment is also called Complete Decongestive Therapy. It consists of a two-phase intensive and maintenance program, that combines manual lymphatic drainage, bandaging, compression garments, skincare, and exercise. Its success depends on that it must be administrated by a skilled Certified Physical Therapist with experience. CDT is generally considered safe, however, there are some contraindications, which is why patients should consult with their doctor before starting treatment. 

After the initial treatment (Phase 1), which is applied daily and lasts several weeks, it then goes onto the maintenance treatment (Phase 2). In this second long-lasting phase, patients are taught self-bandaging for maintenance, basic skincare, and the practice of motion exercises.

By no means should this highly specialized treatment, be substituted by non-professionals or patient self "edema-reduction" treatments. The International Society of Lymphology (ISL) warns in the International Consensus Document, that self bandaging to reduce edema can produce grave complications. There is also little robust scientific evidence to support patient self-administered lymphatic drainage (SLD), for the reduction of lymphatic edema.

On the other hand, treatment consisting of the sole use of Intermittent pneumatic compression (IPC), without previously applied manual lymphatic drainage, by skilled Certified Physical Therapists, can likewise be harmful to patients. Pneumatic compression therapy can surely reduce edema, but in the case of lymphedema it only drains the liquid part, and not, in the same way, the proteins, and its progressive concentration may favor the development of fibrosis. According to the ISL International Consensus Document, careful observation must also be made to avoid possible displacement of edema in the limb and genital área. 

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

Nowadays one must be very cautious with the new terminology that is being used, to define treatment for lymphedema, as can be the term "Decongestive Lymphatic Therapy" (TLD), which is not the same as "Complete Decongestive Therapy" ( TDC). Read more about the new terminology HERE.


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Welches ist die beste Behandlung für Lymphödeme / што з'яўляецца лепшым сродкам для лячэння лимфедемы / což je nejlepší léčba lymfodémy / som er den bedste behandling for lymfødem / joka on paras hoito Lymfedeema / quel est le meilleur traitement pour le lymphoedème / που είναι η καλύτερη θεραπεία για το λεμφοίδημα / שהוא הטיפול הטוב ביותר עבור lymphedema / जो लिम्पेडेमा के लिए सबसे अच्छा उपचार है / amely a lymphedema legjobb kezelése / yang merupakan pengobatan terbaik untuk lymphedema / sem er besta meðferðin fyrir eitilfrumnafæð / quale è il miglior trattamento per il linfedema / yaiku perawatan paling apik kanggo lymphedema / kuris yra geriausias gydymas limfedemai / wat ass déi beschten Behandlung fir Lymphödem / yang merupakan rawatan terbaik untuk lymphedema / wat de beste behandeling is voor lymfoedeem / som er den beste behandlingen for lymphedem / który jest najlepszym lekarstwem na obrzęk limfatyczny / qual é o melhor tratamento para o linfedema / care este cel mai bun tratament pentru limfedem / что является лучшим методом лечения лимфедемы / vilket är den bästa behandlingen för lymfödem / lenfödem için en iyi tedavi hangisidir / đó là cách điều trị tốt nhất cho bệnh bạch huyết / وهو أفضل علاج للوذمة اللمفية / ដែលជាការព្យាបាលដ៏ល្អបំផុតសម្រាប់ lymphedema / 這是淋巴水腫的最佳治療方法 / 임파 부종에 가장 좋은 치료법 / リンパ浮腫の最良の治療法である / ലിംപേദെമയ്ക്കുള്ള ഏറ്റവും മികച്ച ചികിത്സയാണ് ഇത് / जसले लिम्बुमामाको लागि उत्तम उपचार गर्दछ / ซึ่งเป็นวิธีที่ดีที่สุดในการรักษา lymphedema / đó là cách điều trị tốt nhất cho bệnh bạch huyết.
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