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Erika Van Der Mescht

Erika Van Der Mescht

Lymphoedema Association of South Africa, South Africa

Title: Educating patients and health care providers about how complete decongestive therapy (CDT) can help reduce the risk of developing severe lymphoedema

Biography

Biography: Erika Van Der Mescht

Abstract

Lymphoedema is often overlooked as a manageable condition as it is not directly life-threatening or debilitation in the early stages. Or in many cases, it is wrongly diagnosed as merely a chronic edema. But chronic edema for 3 months or longer should be diagnosed as lymphoedema secondary to a specific cause: (1) Primary lymphoedema is rare and in many cases health care providers not referring for complete decongestive therapy is because of a lack of awareness about the possible treatment options. In the past 30 years, there has been a lot of research regarding lymphoedema management, of which all added to the development of complete decongestive therapy as the gold standard for lymphoedema treatment. (2) There has also been a randomized, single blinded, clinical trials’ proving that lymphoedema risk reduction protocols are successful. (3) Surgical studies have been done recently mostly showing good promise in reducing limb volume, but most of these studies are done in combination with complete decongestive therapy before, during or after surgery is performed. (4) Some studies have investigated the negative effect of lymphoedema on quality of life. (5) And even if only that is the objective of lymphoedema management, education for early referral and interventions for lymphoedema is vitally important. There are early studies using near-infrared fluorescence imaging, proving a visible effect on contractile lymphatic function after doing manual lymph drainage to create anastomoses to non-affected areas and (6) even though this has been clinically seen for many years. The goal of the session is to emphasize the importance of educating health care providers to diagnosing primary and secondary lymphoedema in the early stages of the condition in order to prevent debilitating, deformed limbs, which has detrimental effects on a patient’s health, work, social life and activities of daily living.

References

  1. Keast D H, Allen J O, Despatis M and Brassard A (2014) Chronic oedema/lymphoedema: Under-recognised and under-treated. Int Wound J; 12(3): 328-33.
  1. Lasinski M M, Thrift K M, Squire D, Austin M K, Smith K M, Wanchai A, Green J M, Stewart B R, Cormier J N, Armer J M (2012) A Systematic Review or the Evidence for Complete Decongestive Therapy in the treatment of Lymphedema from 2004 to 2011. PM R; 4(8): 580-601.
  1. Torres Lacomba M, et al. (2010) Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomized, single blinded, clinical trial. BMJ; 340.

 

  1. B B Lee, J Laredo and R Neville (2011) Current status of lymphatic reconstructive surgery for chronic lymphedema: It is still an uphill battle! Int J Angiol; 20(2): 73-80.
  1. Kim S J, Kwon C H, Yi O Y (2007) Effect of complex decongestive therapy and the quality of life in breast cancer patients with unilateral lymphedema. Lymphology; 40(3): 143-51.

 

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