Miss Huang, a 56-year-old, found that her right upper arm was swollen after right breast cancer surgery, and she could not sleep on her side, which seriously affected her quality of life. She went to Zhongrong Plastic Reconstruction Surgery Clinic, and the doctor found that it was caused by lymphedema. After evaluation, she underwent surgery. The postoperative condition was good and the edema of the right upper arm improved. At present, she continues to follow up in the clinic.
The etiology of lymphedema of limbs is mostly advanced, which may lead to elephantiasis.
Dr. Lai Zhisheng, Zhongrong Reconstruction Plastic Surgery, introduced that lymphedema of limbs is a phenomenon that lymphatic reflux slows down or is blocked, so that lymph accumulates in the affected limb and causes swelling; The causes are mostly severe trauma, tissue infection, surgery or cancer radiotherapy, or congenital unknown reasons.
However, the clinical manifestations of lymphedema of limbs are heavy feeling, edema and occasional pain in the affected limb, which mostly occurs in one limb and is also prone to cellulitis. Late limb lymphedema will have skin changes, such as discoloration, verrucous hyperplasia, hyperkeratosis, and finally deformity will cause elephantiasis.
There are three treatments for lymphedema of limbs, starting with conservative rehabilitation.
At present, the treatment methods of limb lymphedema can be divided into medical conservative treatment (such as raising limbs and wearing compression clothes), surgical physiological and surgical treatment (such as the connection of lymphatic vessels and venous tubes, lymphatic tissue flap transplantation) and surgical resection (such as subcutaneous edema tissue resection or fat resection).
After defining the general lymphedema of limbs, Dr. Lai Zhisheng said that most of them would recommend conservative rehabilitation treatment, and the main treatment methods are as follows:
1. Limb-lifting movement-increases lymphatic reflux of superficial limbs, but generally it will reflux when lowering limbs.
2. Elastic bandage pressurizes the limb-The elastic bandage is wrapped around the limb, which can promote lymphatic reflux and wrap it from the end of the limb to the proximal end, but pay attention to the tightness of the winding. Too loose has no effect, and too tight will cause skin damage.
3. Limb * * *-Pressing limbs with bare hands can promote lymphatic reflux, but it is not suitable for skin wound infection or other skin diseases.
4. Pneumatic compression of limbs-wear sleeves or socks, and use the extrusion of pneumatic pump to promote lymphatic reflux; Generally, it can only be provided in professional rehabilitation places.
5. Wear pressure suit-Wearing pressure suit can also promote lymphatic reflux, but the climate in Taiwan Province Province is hot and humid in summer, and it is too stuffy to wear for a long time, which makes it difficult for patients to cooperate and even complicated with skin diseases.
Conservative treatment is ineffective, and it is suggested to improve the surgical method.
In addition, if the problem of limb lymphedema cannot be improved by conservative medical treatment and surgical and physiological surgery, subcutaneous edema tissue resection or fat resection is recommended, but after surgical resection, pressure clothing is still needed to reduce the recurrence of limb lymphedema.
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