1. [Lymphedema of the limb: predictors of efficacy of combined physical therapy]
- Author
-
N, Gironet, F, Baulieu, B, Giraudeau, L, Machet, C, Toledano, J, Tiguemounine, G, Lorette, and L, Vaillant
- Subjects
Adult ,Aged, 80 and over ,Male ,Extremities ,Middle Aged ,Prognosis ,Bandages ,Treatment Outcome ,Venous Insufficiency ,Drainage ,Humans ,Female ,Lymph Nodes ,Lymphedema ,Radionuclide Imaging ,Physical Therapy Modalities ,Aged ,Retrospective Studies - Abstract
Limb lymphedema results from incompetence of the lymphatic system, and treatment of both primary and secondary forms involves manual lymphatic drainage and support. The effectiveness of treatment varies from patient to patient and can be unpredictable.To investigate clinical and paraclinical criteria able to predict responses to combined physical treatment (lymphatic drainage and multilayered support) during hospitalization.A retrospective study was performed in 45 patients admitted for one week's intensive treatment of limb lymphedema in the Lymphology Unit of the Department of Dermatology of the University Hospital of Tours. Lymphoscintigraphy was performed for all patients on admission. Loss of volume in affected limbs was studied to evaluate the effectiveness of treatment.Two criteria were predictive of resistance to combined treatment, i.e. venous insufficiency and continuing lymph node evidence of scintigraphic activity four hours after lymphoscintigraphy. The two factors were significantly related.Failure of combined physical treatment for lymphedema appears to be related to venous insufficiency. It is therefore essential to investigate and treat venous insufficiency, particularly in patients with continuing evidence of scintigraphic activity in lymph nodes.
- Published
- 2004