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LYMPHOEDEMA AND ITS COMPLICATIONS TREATMENT (CDP WITH MEDICAL THERAPY)
D. CORDA
The most frequent complication in patients with chronic lymphostasis is erysipelas also known as lymphangitis or cellulitis. In the absence of adequate decongestion, antibiotic therapy is not sufficient to significantly reduce the amount of bacteria. This eventually leads to chronicity of infection with progressive worsening of the clinical features of involved soft tissues. In recent years, we have observed multi antibiotic resistance of bacteria localized on the skin wounds of patients affected by chronic lymphostasis. It is increasingly difficult to eradicate the infection and the consequent progressive chronic inflammation leads to critical tissue degeneration. In this work, we report data obtained from the implementation of pharmacological programs in tandem with decongestive therapy designed to treat acute and above all chronic persistent infections. The results show that this approach seems decisive and specific for the treatment of lymphoedema patients complicated by chronic infections.
Key words: lymphoedema, lymphangitis, erysipelas, cellulitis.
RESTORATION OF LYMPHATIC FUNCTION: FREE VASCULARIZED LYMPH NODE TRANSFER WITH AFFERENT LYMPHATICOLYMPHATIC AND AFFERENT LYMPHATICO-NODULAR ANASTOMOSIS
T. AUNG 1, M. RANIERI 1, S. GEIS 1, P. LAMBY 1, S. KLEIN 1, R. MÜLLER-WILLE 2, W.A. WOHLGEMUTH 2, KATJA EVERT 3,
J. DOLDERER 1
1 Center of Plastic, Hand and Reconstructive Surgery, University Medical Center Regensburg, Germany 2 Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany.
3 Department of Pathology, University Regensburg, Regensburg, Germany
L. PRANTL 1,
Lymphatic malformations (LMF) are characterized by abnormal formation of lymphatic vessels and tissue overgrowth. The lymphatic vessels present in LMF lesions may become blocked and enlarged as lymphatic fluid collects, forming a mass or multicyst. Lesions are typically diagnosed during childhood, and are often disfiguring and life threatening. Available treatments consist of sclerotherapy, surgical removal and therapies to diminish complications.
Lymphatic malformations in inguinal region and inguinal lymphnode dissection is a challenging operation to occur without lower extremity lymphedema (LEL). Here, we report the first case of the resection of a lymphatic malformation and Dissection of the inguinal Lymph node and simultaneously we complete the reconstruction with mini abdominal plastic with vascularized lymph node transfer (VLNT) from ipsilateral and free VLNT from contralateral suprainguinal lymphnode with afferent lymphaticolymphatic anastomosis(ALLA) and Afferent lymphatico nodular anastomosis (ALNA).
The VLN was harvested from the ipsilateral and contralateral suprainguinal region under Indocyanine green (ICG) lymphography and patent blau navigation and transferred to the right goin region. The efferent lymph vessel of the VLN was supermicrosurgically anastomosted to the contralateral medial thigh lymphatic vessel.
Postoperative, there were no subjective or objective lymphedema on the right side and further on the left side. The patient needed nomore compression garment and manual lymph drainage. Further postoperative ICG lymphography showed the restoration of the lymphatic function.
MULTIMODALITY TREATMENT FOR LYMPHOEDEMA – MY EXPERIENCE
Prof. Dr. GURUSAMY MANOKARAN
Chief of lymphology services, Prof of plastic and reconstructive surgery, Amrita institute of medical science and research centre, Kochin, Kerala , India
Lymphoedema is as old as human race itself but the treatment has not progressed much because of poor understanding of its patho physiology.
Though India has the highest number of Lymphoedema patients as LF is very common cause of Lymphoedema in my country and there is no proper Center to treat this problem all under one roof and we don't have any training centre to train this therapist for MLD and Bandaging, until we started in our Center to teach this by using volunteers as our trainers .now our hospital (Amrita institute of medical science and research centre, Kochin) is the only Center in our country to do all under one roof . The foot hygiene , CDT, Pressure garments ,and the various surgical options are available under one roof. Our experience and our result will be discussed in detail in my power point presentation .
Our result shows combining MLD Bandaging with surgery followed by pressure garments gives the best out come for Lymphoedema of any etiology .
Which will be shown in my presentation.
THE EUROPEAN JOURNAL OF LYMPHOLOGY - Vol. XXIX - Nr. 76 - 2017
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