How to treat lymphedema

Lymphedema, also known as elephantiasis, is a common clinical problem. There are two main types of lymphedema: acute lymphedema and chronic lymphedema. The issues and treatments for different types of lymphedema are different. Therefore, the main thing to pay attention to when dealing with the problem of lymphedema is to prescribe the right medicine for the disease. So how should lymphedema be treated?

1. Postural drainage

The drooping state of the limbs aggravates the retention of lymph fluid in the tissue spaces. Raising the affected limb by 30 to 40 cm and utilizing gravity can promote the return of lymph fluid and reduce edema. This method is not simple and effective, but the effect is not long-lasting, and the drooping edema of the affected limb worsens again.

2. Pressure bandage

On the basis of postural drainage, elastic stockings or elastic bandages are used to apply pressure at the toe height of the affected limb to squeeze the tissue gaps and assist lymphatic return. The elastic bandage should be of appropriate tightness. The intermittent pressor can also be used multiple times and for a long time, which has a certain effect on improving edema. Literature reports that foreign countries currently use the lymphatic pressurizer (lymha-press), a more advanced and effective pressurized inflation device. The inflation device is divided into 9 to 12 pieces, each of which can be inflated and pressurized separately. The pressure is gradually applied from the distal end of the limb to the proximal end, and one cycle is less than 25. This lymphatic pressurization device has a greatly shortened inflation and pressurization time compared to other simple pressurization devices (the cycle of a simple pressurization inflation device is about 100 seconds), and can generate a higher pressure of 15.6-20.8 kPa (120-160 mmHg), which is more effective in reducing swelling than surgical operations and simple elastic stockings. However, its use is more complicated and it cannot reduce the protein content in the interstitial space. It is only suitable for short-term treatments such as acute phases and preoperative preparations.

3. Limit sodium intake and use diuretics

In the acute phase, sodium chloride intake should be appropriately limited, generally 1 to 2 g/d, to reduce tissue sodium and water retention. At the same time, use appropriate amounts of diuretics to speed up the excretion of water and sodium. You can use hydrochlorothiazide 25 mg each time, 3 times a day, and take appropriate potassium supplements. Stop taking it after the condition stabilizes.

4. Prevent infection

Using antifungal ointments and powders and keeping the toes dry are the most effective ways to prevent and control fungal infections. Bacterial infections under the nail beds are also common, so you should trim your nails frequently, remove dirt, and reduce the pathways for bacterial invasion. When streptococcal infection causes systemic symptoms, drugs such as penicillin should be used, combined with bed rest, to actively control the infection. In the late stage of lymphedema complicated by skin cracks, ointment can be applied externally to protect and lubricate the skin.