viernes, 28 de junio de 2019

WHAT IS THE BEST TREATMENT FOR ELEPHANTIASIS. How can lymphatic elephantiasis be treated – Pediatric and Primary Lymphedema -Secondary Lymphedema - Lymphatic Filariasis – Podoconiosis - Dermatolymphangioadenitis (DLA) – Rare Disease

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.

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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