Abstract
Lymphedema (lymphatic edema) is a serious progressive lifelong disease of lymphatic system, which influences patients physically and mentally. Untreated or treated incorrectly, lymphedema reduces quality of life and threatens the patient with complications, disability and malignant proliferation.
Lymphedema is caused by the insufficient transport of lymph circulation with consequent congestion of tissue fluid and macromolecular substance, mainly blood proteins, in the interstitium of the cutis and subcutis. The cause of genesis lymphedema can be in a developmental disorder-lymphangiodysplasia (primary lymphedema), or a secondary affection of the lymphatic system, e.g. metastatic invasion, radical oncosurgical intervention, radiotherapy, trauma, iatrogenic damage of the lymphatic system, etc. (secondary lymphedema).
In lymphedematous tissue occur chronic inflammation and fibrous restructuring. Diagnosis of lymphedema is usually based on a evaluation of patient's personal history and the clinical examination of the extremities visually and by palpation, unclear cases are specified through supplementary examinations (lymphoscintigraphy in the first place).
Early diagnosis of the lymphedema is very important because it increases significantly the chance of therapeutical success. The treatment of lymphedema is based on a complex of physical procedures, which cover manual lymphatic drainage, instrumental pressotherapy, bandaging and the wearing of the elastic stocking, special exercises, proper skincare and lifestyle adjustment.
To the supplementary therapeutic measures belong self-treatment, pharmacotherapy, psychotherapy and surgical treatment. Complex physical therapy usually takes place in two stages.
In the first phase, reduction of swelling, we try to gain the maximum reduction of the swelling and the second, maintenance, phase of treatment is aimed at maintaining an improved state of the limbs. Early diagnosis and in time started proper treatment based on the good compliance with a patient makes the prognosis of lymphedema favourable.