Lee BB, Andrade M, Antignani PL, Boccardo F, Bunke N, Campisi C, Damstra R, Flour M, Forner-Cordero I, Gloviczki P, Laredo J, Partsch H, Piller N, Michelini S, Mortimer P, Rabe E, Rockson S, Scuderi A, Szolnoky G, Villavicencio JL, International Union of Phlebology, et al.
International angiology : a journal of the International Union of Angiology. Date of publication 2013 Dec 1;volume 32(6):541-74.
1. Int Angiol. 2013 Dec;32(6):541-74.
Diagnosis and treatment of primary lymphedema. Consensus document of the
International Union of Phlebology (IUP)-2013.
Lee BB(1), Andrade M, Antignani PL, Boccardo F, Bunke N, Campisi C, Damstra R,
Flour M, Forner-Cordero I, Gloviczki P, Laredo J, Partsch H, Piller N, Michelini
S, Mortimer P, Rabe E, Rockson S, Scuderi A, Szolnoky G, Villavicencio JL;
International Union of Phlebology.
Author information:
(1)Center for Vein, Lymphatics, and Vascular Malformation, Division of Vascular
Surgery, Department of Surgery, Georgetown University School of medicine,
Washingto DC, USA.
Primary lymphedema can be managed effectively as a form of chronic lymphedema by
a sequenced and targeted treatment and management program based around a
combination of Decongestive Lymphatic Therapy (DLT) with compression therapy,
when the latter is desired as an adjunct to DLT. Treatment in the maintenance
phase should include compression garments, self-management, including
self-massage, meticulous personal hygiene and skin care, in addition to
lymphtransport-promoting excercises and activities, and, if desired, pneumatic
compression therapy applied in the home. When conservative treatment fails, or
gives sub-optimal outcomes, the management of primary lymphedema can be
improved, where appropriate, with the proper addition of surgical interventions,
either reconstructive or ablative. These two surgical therapies can be more
effective when fully integrated with manual lymphatic drainage (MLD)-based DLT
postoperatively. Compliance with a long-term commitment to MLD/DLT and
particularly compression postoperatively is a critical factor in determining the
success of any new treatment strategy involving either reconstructive or
palliative surgery. The future of management of primary lymphedema has never
been brighter with the new prospect of gene-and perhaps stem-cell oriented
management.
PMID: 24212289 [Indexed for MEDLINE]
