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A Journal on Phlebology

Official Journal of the Italian College of Phlebology
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Acta Phlebologica 2004 December;5(2-3):45-50

language: English, Italian

Combined medical and physical therapy in the treatment of primary and secondary lymphedema of lower limbs

De Franciscis S. 1, Serra R. 1, Perziano A. 1, Torcia G. 1, Inzitari M. T. 2

1 Division of Surgery, Unit of Vascular Surgery, “Magna Graecia” University of Catanzaro, Catanzaro, Italy;
2 Department of Orthopedics, Mater Domini University “Magna Graecia” University of Catanzaro, Catanzaro, Italy


AIM: Lymphedema is a chronic disease, with high incidence in world population. It results from a defect of the lymphatic system. Nowadays many kinds of treatment can be used for lymphedema and most of them may give a temporary improvement but cannot resolve definitively the disease. Aim of this study is to demonstrate that combined medical and physical treatment represent the “gold standard” in the treatment of lymphedema.
METHODS: From January 2002 to February 2003, 67 patients with primary and secondary lymphedema have been selected and treated. Medical therapy with benzopyrones (coumarin and diosmin) in all 67 patients was performed; intermittent pneumatic compression in all 67 patients were performed after manual lymph drainage according to Vodder and Foeldi technique and between treatment sessions all patients worn continuously elastic support garments.
RESULTS: After 14 months of treatment, a decrease of hardness of oedema was observed in all 6 patients (100%) at I stage; a decrease of hardness of oedema was observed in 14 out 15 patients (93%) at II stage, in 34 out of 35 patients (97%) at III stage, in 8 out of 9 patients (89%) at IV stage and in 1 out 2 patients (50%) at V stage.
CONCLUSIONS: In our experience combined medical and physical treatment represents the “gold standard” in the treatment of lymphedema of lower limbs. Only by combining medical and physical therapy, according to the developing stage and the moment strategy clinically valid results could be achieved.

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