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ISSN 0350-2899, 34(2009) 1 pp.54-66
Lymphatic Diseases: Therapeutic Principles
(Oboljenja limfatika: terapijski principi)
KLINIČKOBOLNIČKI CENTAR „ZVEZDARA”, BEOGRAD
is severe, chronic, progressive, longlasting and incurable disease.
Until nowadays, the therapy of lymphedema is an unsolved problem.
The disease can be treated but not cured, and it is probably more
appropriate to say that we can treat the disease and offer some help
to patients, but cannot cure them. All treatment options can be
divided into conservative (nonoperative) and surgical (operative)
methods, but the classification is didactical and conditional,
because the therapeutic approach often includes numerous methods in
different combinations. Conservative (nonoperative) methods of
treatment are: manual lymphatic drainage, external medical
compression (pneumatic pumps, compressive bandages and binding),
ultrasound, laser therapy, elevation of the extremity and many other
which are in the experimental phase of research. Three different
groups of medications are used in lymphedema treatment: Benzopyrones
(Coumarine), Flavonoids and RutosidesRutine Family, but with minor
results. Gene therapy and the application of the so called “Smart
Drugs” are the attempts which are in the experimental phase of
research and at the beginning of preclinical studies. Surgical
treatment of lymphedema consists of more than 100 surgical
procedures, including their modifications and combinations. These
procedures can be divided into: procedures with resection (excision,
including lymphosuction), drainage procedures, reconstructive and
combined operations. Prevention of lymphedema development,
precaution measures and adequate medical care of developed
lymphedema are very complex but significantly improve the quality of
life of patients. Combined (complex) Decongestive Physiotherapy is
the most acceptable method of treatment for the lymphedema of the
extremities today, and can be considered as a “golden standard”.
Surgical therapy is reserved for the most severe forms of the
disease or as an addition to physiotherapy.
Key words: Lymphedema / therapy, surgery, prevention, adverse effects
Dr Mile Ignjatović
Dimitrija Tucovića 161, 11000 Beograd
|Paper received: 31.03.2009.
Paper accepted: 08.04.2009.
Published online: 21.05.2009.
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