|
MEDICAL
PROFESSION AWARENESS
Although lymphedema has afflicted children and
adults for centuries, little understanding about diseases of the lymph
trunks existed until relatively recently. Not until 1934 was primary
lymphedema described as a clinical entity, and only in the past 10
to 15 years have therapists and clinicians begun to focus more vigorously
on its treatment. According to the World Health Organization, lymphedema
affects 250 million people worldwide. Others estimate that one in
every 25 will suffer from some form of lymphedema during their lifetime.
In the industrialized world, as cancer rates increase, so, too will
the incidence of lymphedema.
THE
LYMPHATIC SYSTEM
The lymphatic system, an off-shoot of the
blood circulation system, develops embryologically from the venous
system. Tissue fluid and protein, lipids, fat, soluble vitamins (A,
D and K) and immune cells circulate within lymph vessels and lymph
nodes back to the venous systems. When lymphatic drainage is impaired,
edema fluid and protein gradually collect and stagnate in the soft
tissues providing a natural culture medium for later bacterial infection.
TREATMENT
Over the past 15 years,
several successful treatment modalities have evolved. When lymphedema
is diagnosed promptly and treatment begun early (usually with sequential
gradient pump, manual lymph drainage and form-fitting compression
garments), patients can enjoy productive lives with few complications
and little or no restriction on lifestyle. However, when lymphedema
remains undiagnosed or untreated for prolonged periods of time, the
outcome often is disabling, painful, costly and, at times, even life-threatening.
1 Piller, N.B.: Pharmacological
Treatment of Lymph Stasis. Olszewski, W.L: Lymph Stasis; Pathophysiology,
Diagnosis and Treatment. CRC Press, Boca Raton, 503, 1991.
2 Smeltzer, D.M.; Stickler, G.B.; Schirger, A.: Primary Lymphedema
in Children and Adolescents: A follow-up Study and Review. Pediatrics,
76:206-215, 1985.
Marlys Witte, M.D., is a Professor of Surgery at the University of
Arizona, Tucson, and Secretary-General of the ISL.
|
