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[Treatment of limbs lymphedema].

Identifieur interne : 000318 ( France/Analysis ); précédent : 000317; suivant : 000319

[Treatment of limbs lymphedema].

Auteurs : Loïc Vaillant [France] ; Christine Müller ; Pascal Goussé

Source :

RBID : pubmed:20850261

Descripteurs français

English descriptors

Abstract

The treatment of lymphedema aims to reduce the volume and prevent infectious and joints mobility complications. This treatment rarely cure and is usually symptomatic; thus it should be continued throughout the life. The erysipelas and lymphangitis are common complications of lymphedema. Erysipela is always of streptococcal origin and requires systemic antibiotics. The risk of recurrent erysipelas on lymphedema is high. In case of large swelling associated with significant dermal sclerosis, it may lead to decrease joint mobility and functional impairment. The skin cares, manual lymph drainage, compression therapy with bandages and exercises are the four pillars of the complex decongestive therapy of limb lymphedema. Compression is the most important treatment. Lymphedema can be improved by only bandages, but a sustained improvement of lymphedema cannot be seen without bandages. The effectiveness of treatment must be evaluated by objective methods, measuring the perimeters of members or volumes. The management of lymphedema includes three phases: attack or initial treatment that aims to reduce volume of the lymphedema and maintenance phase to maintain the result and finally withdrawal phase. In the attack phase, we use complex decongestive therapy, mainly multilayer inelastic bandaging and manual lymphatic drainage (MLD). In the maintenance phase, we use elastic compression (stockings or sleeves) possibly associated with MLD. At all stages skin care and exercises are used. Adjuvant treatments may be useful (intermittent pneumatic compression, drug treatment). Surgery is rarely used except for genital lymphedema. The therapeutic management of lymphedema is difficult but has a variety of techniques. The complex decongestive therapy is very effective to restore a better quality of life even though it does not provide a cure for lymphedema.

DOI: 10.1016/j.lpm.2009.12.011
PubMed: 20850261


Affiliations:


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pubmed:20850261

Le document en format XML

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<term>Chronic Disease</term>
<term>Combined Modality Therapy</term>
<term>Compression Bandages</term>
<term>Erysipelas (etiology)</term>
<term>Erysipelas (prevention & control)</term>
<term>Extremities</term>
<term>Humans</term>
<term>Intermittent Pneumatic Compression Devices</term>
<term>Lymphangitis (etiology)</term>
<term>Lymphangitis (prevention & control)</term>
<term>Lymphedema (complications)</term>
<term>Lymphedema (etiology)</term>
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<term>Association thérapeutique</term>
<term>Bandages de compression</term>
<term>Dispositifs à compression pneumatique intermittente</term>
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<term>Hygiène de la peau</term>
<term>Lymphangite ()</term>
<term>Lymphangite (étiologie)</term>
<term>Lymphoedème ()</term>
<term>Lymphoedème (étiologie)</term>
<term>Maladie chronique</term>
<term>Manipulations de l'appareil locomoteur</term>
<term>Membres</term>
<term>Reprise du traitement</term>
<term>Équipe soignante</term>
<term>Érysipèle ()</term>
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<term>Lymphoedème</term>
<term>Érysipèle</term>
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<term>Manipulations de l'appareil locomoteur</term>
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<div type="abstract" xml:lang="en">The treatment of lymphedema aims to reduce the volume and prevent infectious and joints mobility complications. This treatment rarely cure and is usually symptomatic; thus it should be continued throughout the life. The erysipelas and lymphangitis are common complications of lymphedema. Erysipela is always of streptococcal origin and requires systemic antibiotics. The risk of recurrent erysipelas on lymphedema is high. In case of large swelling associated with significant dermal sclerosis, it may lead to decrease joint mobility and functional impairment. The skin cares, manual lymph drainage, compression therapy with bandages and exercises are the four pillars of the complex decongestive therapy of limb lymphedema. Compression is the most important treatment. Lymphedema can be improved by only bandages, but a sustained improvement of lymphedema cannot be seen without bandages. The effectiveness of treatment must be evaluated by objective methods, measuring the perimeters of members or volumes. The management of lymphedema includes three phases: attack or initial treatment that aims to reduce volume of the lymphedema and maintenance phase to maintain the result and finally withdrawal phase. In the attack phase, we use complex decongestive therapy, mainly multilayer inelastic bandaging and manual lymphatic drainage (MLD). In the maintenance phase, we use elastic compression (stockings or sleeves) possibly associated with MLD. At all stages skin care and exercises are used. Adjuvant treatments may be useful (intermittent pneumatic compression, drug treatment). Surgery is rarely used except for genital lymphedema. The therapeutic management of lymphedema is difficult but has a variety of techniques. The complex decongestive therapy is very effective to restore a better quality of life even though it does not provide a cure for lymphedema.</div>
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