Lymphoedema: Pathophysiology and management in resource-poor settings - relevance for lymphatic filariasis control programmes
Identifieur interne : 008E53 ( Main/Exploration ); précédent : 008E52; suivant : 008E54Lymphoedema: Pathophysiology and management in resource-poor settings - relevance for lymphatic filariasis control programmes
Auteurs : Babar Vaqas [Royaume-Uni] ; Terence J. Ryan [Royaume-Uni]Source :
- Filaria Journal [ 1475-2883 ] ; 2003.
Abstract
Low cost reduction of morbidity in lymphoedema is an essential goal in the management of lymphatic filariasis. This review emphasises the role of movement and elevation, and refers to the literature on the effects of these on the venous and lymphatic system. The patient with lymphoedema becomes increasingly immobile and the affected limb is often in a permanently dependent position causing venous hypertension and resultant overloading of the failing lymphatics. The evidence that breathing exercises are important for reducing venous hypertension and inducing lymphatic flow is discussed.
The contribution of a damaged epidermis to lymphatic failure is emphasised. Loss of barrier function encourages penetration of bacteria and stimulates repair mechanisms that generate cytokines, which, in turn lead to inflammation. Management programmes that improve the health of the epidermis play a part in reducing lymphatic load.
In taking morbidity management of lymphoedema into the general health services there are benefits in promoting skin hygiene and self-help regimes that can ameliorate many diseases along with lymphoedema.
Url:
DOI: 10.1186/1475-2883-2-4
PubMed: 12685942
PubMed Central: 153482
Affiliations:
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Ryan</name><affiliation wicri:level="1"><nlm:aff id="I2">Oxford Centre for Health Care Research & Development, 44 London Road, Headington, Oxford, OX3 7PD, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Oxford Centre for Health Care Research & Development, 44 London Road, Headington, Oxford, OX3 7PD</wicri:regionArea><wicri:noRegion>OX3 7PD</wicri:noRegion></affiliation></author></analytic><series><title level="j">Filaria Journal</title><idno type="eISSN">1475-2883</idno><imprint><date when="2003">2003</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Low cost reduction of morbidity in lymphoedema is an essential goal in the management of lymphatic filariasis. This review emphasises the role of movement and elevation, and refers to the literature on the effects of these on the venous and lymphatic system. The patient with lymphoedema becomes increasingly immobile and the affected limb is often in a permanently dependent position causing venous hypertension and resultant overloading of the failing lymphatics. The evidence that breathing exercises are important for reducing venous hypertension and inducing lymphatic flow is discussed.</p><p>The contribution of a damaged epidermis to lymphatic failure is emphasised. Loss of barrier function encourages penetration of bacteria and stimulates repair mechanisms that generate cytokines, which, in turn lead to inflammation. 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