It must first be analyzed weather patient basic home setting
management, consisting of skin hygiene, motion exercises and limb
elevation, are enough to reduce and stop progression of lymphedema
towards Stage-III-elephantiasis.
The
effectiveness of basic hygiene, based on skin care, motion exercises, and limb
elevation interventions on lymphedema, is part
of basic daily self-care routine for patients, and meant for
prevention of possible dermal infections, but this is not enough to
prevent Dermatolymphangioadenitis - DLA (Cellulitis), Erysipelas, lymphangitis, or the
progressive inflamation and swelling of oedema. Clinical outcomes on
interventions to manage lymphedema, show that simple hygiene-based
measures are necessary, but this alone will not reduce the limb size
and volume.
All lymphedema whatever the cause or setting, need
reductive compression therapy and compression garments as treatment,
to hold back the progression of the disease. Without daily use of
compression garments, it is impossible in the majority of cases, to
control the chronic progressive swelling of lymphostatic oedema.
Elephantiasis is the advanced form of all Lymphedema whatever the
cause, and special care is necessary for reduction and disability
management.
The best treatment for elephantiasis is CDT (Complete Decongestive Therapy), it is considered "Gold Standard" conservative treatment for the reduction of limb volum. This specialized treatment consists of MLD (Manual Lymphatic Drainage) and Multi-layer bandage wrapping conducted by specialized physiotherapists, as well as other components such as skin care, diet and excercises. Radical reductive ablative surgery, aimed to remove the diseased skin and subcutaneous tissue, should always be the last option, for it is frequently associated with significant blood loss, morbidity, infections, permanent disfigurement and recurrence of symptoms.
lymphedema without compression treatment and garments, even with the intervention of simple hygiene-based measures and elevation of limbs, is not enough to control inflammatory episodes of bacterial dermatolymphangioadenitis (DLA). Available evidence strongly supports the effectiveness of management of lymphedema with good reduction therapy and compression garments, to control the progression and advance of the disease.
The best treatment for elephantiasis is CDT (Complete Decongestive Therapy), it is considered "Gold Standard" conservative treatment for the reduction of limb volum. This specialized treatment consists of MLD (Manual Lymphatic Drainage) and Multi-layer bandage wrapping conducted by specialized physiotherapists, as well as other components such as skin care, diet and excercises. Radical reductive ablative surgery, aimed to remove the diseased skin and subcutaneous tissue, should always be the last option, for it is frequently associated with significant blood loss, morbidity, infections, permanent disfigurement and recurrence of symptoms.
lymphedema without compression treatment and garments, even with the intervention of simple hygiene-based measures and elevation of limbs, is not enough to control inflammatory episodes of bacterial dermatolymphangioadenitis (DLA). Available evidence strongly supports the effectiveness of management of lymphedema with good reduction therapy and compression garments, to control the progression and advance of the disease.
International protocols and best practice guides recommend simple hygiene-based measures for almost all diseases, but in the case of lymphedema this is not enough for its volume control, and to prevent the progression of its severe clinical manifestations. Lymphostatic oedema without treatment or inadequately treated, are more likely to develop lethal complications, such as septicemia (sepsis) or lymphangiosarcoma.
With reference to
Secondary Lymphedema due to filarial infection (lymphatic
filariasis), there are countries that have successfully interrupted
transmission by means of mass treatment with antiparasitic drugs, but
access to good compression treatment and compression garments to
prevent morbidity management and disability in established lymphedema, has lagged behind and so people continue to suffer from the
disabling and stigmatizing effects of Lymphedema Stage 4-elephantiasis.
CLICK TO SEE VIDEO OF THE BEST TREATMENT OPTION FOR ELEPHANTIASIS-STAGE-4-LYMPHOEDEMA (NON-SURGICAL TREATMENT):
References
of interest:
Consensus
Document of the ISL (International Society of Lymphology)
file:///C:/Users/usuario/Downloads/20106-35060-1-PB.PDF
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