Abstracts LymphForsch 1/2011
Quality management in the field of lymphological compression bandaging
W. Jungkunz, P. Melinic, T. Ott, B. Nink-Grebe, H. M. Seipp, LymphForsch 2011; 15(1) 6-8
During an advanced training course on the lymphatic system, 13 experienced lymph therapists prepared compression bandages using commercially available lymphedema sets on two standardized model legs of normal physiological size for measuring. Each set was equipped with 16 hidden pressure sensors. The pressure and pressure progress were registered and evaluated. The results showed that none of the 13 therapists obtained an acceptable pressure profile. Only one of them administered a consistent pressure profile. The recommended pressure in the area of the ankle was far below the desired level, in some cases by 50 %, except for one therapist, who used an additional customized foam pad. From these results we can deduce that tremendous deficits exist with respect to the application of medical compression aids. The reason for this may be the lack of measure- ment control in current therapist training. This may be compensated for with the intro- duction of feedback measures: model legs as a consistent test standard allow monitoring of pressure application and validation of the techniques that have been learned.
Keywords: quality management, lymphological compression bandage, complete physical decongestion therapy, pressure sensors
The lymphatic system in inflammation-associated diseases: A widely neglected area of research
K. Buttler, J. Wilting, LymphForsch 2011; 15(1) 9-15
The function of the lymphatics in inflammation-associated diseases have only rarely been studied. The lymphatics are usually regarded as a passive route for circulating leukocytes. Their participation in inflammatory processes is, however, immediately visible in lymphan- gitis. Inflammatory mediators such as interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) induce the secretion of lymphangiogenic growth factors, primarily vascular endo- thelial growth factor-C (VEGF-C). Lymphangiogenesis then appears to modulate the pro- cess of inflammation, because lymphatic endothelial cells (LECs) produce factors such as chemokine binding protein-2 (CCBP2 / D6), which binds and inactivates inflammatory chemokines. Therefore, LECs may have a function for the resolution of inflammation. For numerous diseases, it is still unknown whether they are associated with pro- or antilymph- angiogenic mechanisms. In this review, diseases are discussed that are either associated with lymphangiogenesis or with inflammation of the lymphatics, such as: lymphangitis, cat-scratch disease, erysipelas, filariasis, lymphangioma, Crohn‘s disease, rheumatoid arthritis, psoriasis, chronic venous insufficiency, diabetes mellitus, corneal transplant rejection, kidney transplant rejection and Kaposi‘s sarcoma.
Keywords: lymphangiogenesis, inflammation, lymphangitis, erysipelas, lymphangioma, lymphatic endothelium