Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2009     Vol 34     No 1
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      UDK 616.42-005.9

ISSN 0350-2899, 34(2009) 1 pp.54-66


Lymphatic Diseases: Therapeutic Principles
(Oboljenja limfatika: terapijski principi)

Mile Ignjatović



      Summary: Lymphedema 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

Napomena: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian

      Contact address:
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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Journal of Regional section of Serbian medical association in Zajecar
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