Chronic lymphatic system disease caused by accumulation of connective tissue fluids in the interstitium.
The WHO has estimated the prevalence of lymphoedema worldwide to be 300 million cases (about 1 person in 20). In Italy there are 350,000 cases per year.
Secondary lymphoedema is the most frequent (60%) and among these, post-mastectomy lymphoedema is the most common.
In Italy there are about 9,000 new cases/year affected by post-mastectomy lymphoedema.
The lymphatic system helps to ensure the homeostasis of organic liquids.
In physiological conditions, the Lymph has a flow rate of 2 litres/day but this can increase by up to 10 times in pathological conditions
The system actively drains by means of the LYMPHANGION basic unit of the lymphatic tissue.
When the lymphatic system has saturated its drainage capacity and the liquid stagnates in the interstitium, LINFOEDEMA occurs.
The sites most frequently affected are the lower limbs.
Lymphatic stasis caused by slowing down or blocking of lymphatic circulation leads to tissue changes that promote chronic oedema with progressively increasing evolution and with possible onset of complications: erysipelas, lymphatic ulcers, hyperkeratosis and connective tissue fibrosis.
We need to make a distinction:
Primitive or primary lymphoedemas
- Congenital or idiopathic (chromosomes 5,16,18,21)
- Connatale < 1 year: unisegmental, Milroy, Milroy-like
- Precocious < 35 years
- Tardive > 35 years
The most frequent are the late forms that often occur after a triggering event (cast, bandage, insect bite, etc.)
- Tissue traumas and injuries
- Results of venous surgery
- Large scars
- Lymph node metastases
- Compressions from large tumour masses
- Intravenous therapy infections
- Heartworm Infestations
In the vast majority, patients, especially the elderly, have either cardiogenic oedema (treatable with diuretics) or stasis phlebolymphoedema (because they walk little and badly or sleep in an armchair).
In the latter cases the necessary therapies are:
- Natural supplements or diuretics
- Compression therapy + possible pressure therapy
We have a home nursing service specifically for this type of problem.