Abstracts LymphForsch 2/2012
Lipedema and congenital analbuminemia: A rare combination
W. Schmeller, D. Hartwig, LymphForsch 2012,16(2)58-63
We present two Turkish sisters with lipedema in combination with the rare disease conge- nital analbuminemia. While the clinical signs of analbuminemia (fatigue, edema and hypo- tension) are often mild and unspecific, laboratory tests reveal obvious changes in the protein electrophoresis with an extreme reduction of albumin and a reactive increase in globulins. In addition, hyperlipidemia and increased erythrocyte sedimentation rate (ESR) were observed. Since analbuminemia causes few complaints, no further intervention is needed. Lipedema with manual lymph drainage, compression and liposuction, in accordance with guidelines, can be performed as usual.
Keywords: lipedema, analbuminemia, liposuction
Pilot study on compression therapy in patients with lipedema, lymphedema and lipo-lymphedema
S. Reich-Schupke, P. Altmeyer, M. Stücker, LymphForsch 2012,16(2)65-69
Background: Compression treatment is undisputed as the basis of lymphedema therapy. During the initial period of decrease of edema (phase I), compression bandages that are refitted daily should be applied. During the subsequent compression maintenance phase II (prevention of edema and ulcer recurrence), compression garments are recommended. Furthermore, mobility, weight reduction as well as information and compliance of the patients are important parameters for long-lasting success of the therapy. In daily practice, especially in outpatient treatment, theoretical knowledge and practical skills appear to vary greatly.
Objectives: The aim of this open pilot study was to collect data on lymphological com- pression treatment in collaboration with local specialized medical supply stores. The data were collected under„wild conditions“ without the influence of lymphedema networks or prepared structures.
Results: Most striking was the absence of diagnostics prior to lymphological therapy of lipedema or lymphedema in 15 % of the patients, and the complete lack of or incomplete reduction of edema in 50 % of the patients. Moreover, there was a large number of over- weight and obese (55 %), poorly informed and educated (28 %) and immobile (25 %) pati- ents. 90 % of the patients had been prescribed flat-knitted stockings.
Conclusions: Although flat-knitted stockings now appear to be established in lymphe- dema treatment, substantial deficits can be observed in the diagnostics, reduction of edema in the initial period, and the education of patients.
Keywords: compression therapy, reduction of edema, mobility, outpatient treatment
The success story of lymphedema management and complete physical decongestive therapy (CDT) – The state of the art
O. Gültig, LymphForsch 2012,16(2)70-73
The therapy measures required to manage lymphedema go back to the late 19th century, although they initially lapsed into oblivion. Vodder, Asdonk, Földi, Kubik, Weissleder and others were pioneers of 20th and 21st century lymphology. They were joined by the thousands of dedicated lymphedema therapists who, with their daily implementation of complete physical decongestive therapy (CDT) measures, first made possible today‘s disease-specific differentiation and clear treatment concepts.
CDT remains the therapy of choice for lymphostatic edema. It is divided into an initial decongestion phase and a second maintenance/optimizing treatment phase. The astonishing successes can only be achieved through the synergy of all the applied CDT measures.
Lymphedema management is a prime example of teamwork among the medical profes- sions. In particular, in numerous lymphedema networks which have developed at regional level, the results achieved can be documented and evaluated in terms of quality and efficiency.
Keywords: lymphostatic edema, combined physical decongestive therapy (CDT), team-work among the medical professions, networks, documentation, evaluation.
Liposuction in secondary breast cancer related lymphedema: A new therapeutical modality
R. J. Damstra, LymphForsch 2012,16(2)75-78
Breast cancer is the most common malignant disease in women. A frequent complication after therapy is lymphoedema, with an incidence of 1-49%.Today, chronic non-pitting arm lymphoedema of up to four litres in excess can be effectively removed by use of lipo-suction and postoperative compression therapy without any further reduction in lymph transport. Long-term results, up to 15 years, have not shown any recurrence of arm swelling.
Keywords: breast cancer related lymphedema (BCRL), inverse water volumetry, lipo-suction, chronic care management, multidisciplinary therapy
Pilot study on a lymphedema orthopedic bandaging shoe
C. Bromberger, M. Matt, LymphForsch 2012,16(2)80-83
In outpatient lymphedema management, functional lymphological compression bandaging is an indispensable component of complete physical decongestive therapy (CDT). In order to adequately treat working patients so that they are able to maintain their everyday mobility during the decongestion phase and to prevent them from sustaining weather- related injuries, appropriate footwear is required.
The bandaging shoes intended for indoor use currently available do not meet these requirements. A pilot study conducted in cooperation with Schaub orthopedic shoes technology in Freiburg from October 2010 to June 2012 studied 11 patients undergoing functional lymphological compression bandaging. The study yielded important findings and observations about the principles of podiatric orthopedics and its changes in lymphological compression bandaging in conjunction with edema of various severity and, as well as about the requirements of patients with lymphedema.
Keywords: functional lymphological compression bandaging, complete physical decon- gestive therapy (CDT), working patients, pilot study