Diagnosis and Treatment of Primary Lymphedema. Consensus Document of the International Union of Phlebology (IUP)-2013

B Lee, M Andrade, P Antignani, F Boccardo, N Bunke, C Campisi, Robert Damstra, M Flour, J Forner-Cordero, P Gloviczki, J Laredo, H Partsch, Neil Piller, S Michelini, P Mortimer, E Rabe, S Rockson, A Scuderi, G Szolnoky, J Villavicencio

    Research output: Contribution to journalArticlepeer-review

    59 Citations (Scopus)

    Abstract

    Primary lymphedema can be managed effectively as a form of chronic lymphedema by a sequenced and targeted treatment and management program based around a combination of Decongestive Lymphatic Therapy (DLT) with compression therapy, when the latter is desired as an adjunct to DLT. Treatment in the maintenance phase should include compression garments, self-management, including self-massage, meticulous personal hygiene and skin care, in addition to lymphtransport-promoting excercises and activities, and, if desired, pneumatic compression therapy applied in the home. When conservative treatment fails, or gives sub-optimal outcomes, the management of primary lymphedema can be improved, where appropriate, with the proper addition of surgical interventions, either reconstructive or ablative. These two surgical therapies can be more effective when fully integrated with manual lymphatic drainage (MLD)-based DLT postoperatively. Compliance with a long-term commitment to MLD/DLT and particularly compression postoperatively is a critical factor in determining the success of any new treatment strategy involving either reconstructive or palliative surgery. The future of management of primary lymphedema has never been brighter with the new prospect of gene-and perhaps stem-cell oriented management.

    Original languageEnglish
    Pages (from-to)541-574
    Number of pages34
    JournalInternational Angiology
    Volume32
    Issue number6
    Publication statusPublished - Dec 2013

    Keywords

    • Ablative surgery
    • Compliance
    • Compression therapy
    • Decongestive Lymphatic Therapy
    • Gene-oriented management
    • Primary lymphedema
    • Reconstructive surgery
    • Truncular lymphatic malformation

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