lunes, 13 de marzo de 2023

WORLD PODOCONIOSIS DAY 2023 - Lymphatic Vascular Disease - Secondary Lymphedema - Best Practices Management Guideline / Treatment Protocol / Patient Care Pathway - Awareness Campaign

On March 18, people around the world come together to raise awareness of a condition that has effective treatment and to call on national health systems to invest in correct, effective, and safe therapeutic options for all, and to leave no one behind.

Lymphoedema is a neglected disease in many countries, especially in the world's poorest communities. Like other neglected chronic diseases, inaccessibility to the treatment of lymphedema, or the recommendation of low-cost alternative solutions due to the cost-saving policies of some national health systems, can lead to the progression of the disease to its most advanced degree of severity called "Elephantiasis". For patients, this means further disfigurement, disability, discrimination (Social Stigmatization), loss of income, and loss of quality of life (QoL) as can be assessed with the ICF model (International Classification of Functioning, Disability, and Health). Read more about why the world is failing to treat a treatable condition like elephantiasis HERE.

The use of footwear is very important for the prevention of Podoconiosis, but once chronic lymphatic dysfunction (lymphedema) is established, shoes alone are not enough to stop the progression of the disease. Scientific studies highlight the importance of compression therapy in controlling the progression of lymphedema. Clinical results of interventions to control lymphoedema show that simple hygiene-based measures (skin care, exercises, elevation of affected limbs, and use of footwear) are necessary, but these alone are not enough to reduce the volume and size of the extremities. Self-management strategies according to the chronic care model (CCM), where patients with chronic diseases should assume a leading role in their treatment to improve health status, daily functioning, and quality of life, should not and cannot be, a substitute for the correct and necessary treatment that a disease requires.

Lymphedema of the limbs and genitalia should always be treated in its early stages, and not left untreated until they reach Grade III (elephantiasis), and then resorting to aggressive surgeries. Radical reductive ablative surgery (Charles Procedure), aimed to remove the diseased skin and subcutaneous tissue in the elephantiasis stage, should always be the last option for it is frequently associated with significant blood loss, morbidity, infections, permanent disfigurement, and recurrence of symptoms. Read more about what is the best treatment for Elephantiasis HERE.

In relation to “Dermatolymphangioadenitis” (DLA), also known as infectious cellulitis, studies have shown that swelling control is associated with a lower risk of cellulitis, that advanced degrees of chronic edema are a strong risk factor, and also that "Compression Garments" are essential. Infectious Cellulitis can lead to sepsis (Septicaemia). Read more about the risk of Infectious Cellulitis for Lymphoedema HERE.

The United Nations General Assembly endorsed a resolution urging countries to aim towards the goal that everyone, everywhere, should have access to quality health care, and proclaimed 12 December as Universal Health Coverage Day (UHC Day) by resolution 72/138. Millions of people all over the world are suffering from nontreatment or undertreatment of Lymphedema, and are still waiting for correct and effective health care, and many of them are already in the very severe stages (Elephantiasis). 


German Scientific Society Guideline

Therapeutic Efficacy of Complex Decongestive Therapy in the Treatment of Elephantiasis of the Lower Extremities

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