PAPER PRESENTED IN THE 13º INTERNATIONAL CONGRESS OF LYMPHOLOGY - SEPTEMBER 29-OCTOBER 5, 1991 - PARIS, FRANCE.
PUBLISHED IN: R. V. CLUZAN, A. P. PECKING, F. M. LOKIEC, EDITORS. PROGRESS IN LYMPHOLOGY XIII. ELSEVIER SCIENCE PUBLISHERS B. V., AMSTERDAM 1992; 529-532.

INTRODUCTION
The concept of Complex Physical Decongestive Therapy as a treatment of Lymphedema does not belong to this century. Some authors described personal ways of accomplishing it. Sometimes they treated the same subject in a similar way without knowing previous papers refered to conservative treatment. Professor Michael Fóldi could gather the best ideas of all of them and his large experience either in scientific lymphatic research or in practical lymphological medicine allowed him to add his personal criterion and develop a succesful therapeutical system.

 

PURPOSE
To display the results of Fóldi's method in the treatment of patients with primary and secondary lymphedema in Argentina.

 

MATERIALS AND METHODS
32 patients with lymphedema were treated with Fdldi's method (Complex Decongestive Physiotherapy). Intentionally, etiological factors were not considered conditionality for this report. 10 were upper limb lymphedemas (postmastectomy); 22 were lower limb lymphedemas (postsurgery, post oncologic treatment or primary). The treatment comprised: a) Myolimphokinetic gimnastic: To mantain the joints elastic and enable muscle to favor or make better lymphatic and venous circulation through aspiration-compression pump function. b) Manual lymph drainage: It started over the neck and followed over axilla, dorsum, breast, abdomen, contralateral limb and finally over the affected limb always from proximal to distal areas. c) Bandage: Only made by physicians. Strong bandages were used to increase tissue pressure to prevent edema fluid reaccumulation. Simultaneously, 5-6 benzo (alpha) pyrone and Ungüentum Lymphaticum were used. Hygienic measures were taken into account. Circumference limb measurements (at 10 cm intervals) were made daily: before gimnastic and after drainage.

 

RESULTS

All the patients improved significantly. Circumferences and excess fibrosis reduction were excellent as well as mobility of limbs recovery. Lymphangitis crisis disminished glaringly. Lessening of bursting pains, tension and heaviness was most important. Remarkable psychological improvement was often observed.

 

CONCLUSION

Fóldi's method achieves a significant improvement in a short time (4/5 weeks) and follow up displays its effectiveness.

 

PERSONAL CASES

 

Case I: Lymphedema postmastectomy.

The sequence of pictures displays

• The state of the patient before, during and after the Complex Decongestive Physical Therapy (Fdldi's Method) (CDPT). Notice the dates.

• xy graphics displaying the changes in circumference measurements (only one level is shown in this example).

• Upper limb levels where measurements are usually taken.

• Excess skin was cut off one month later.

• Postoperative state (only one week) is displayed.

 

Case II: Primary lower limb lymphedema

The sequence of pictures displays

• The state of the patient before, during and after the treatment (CDPT). Notice the dates.

• xy graphics. In this example, two cycles were performed. Different levels are shown in this case.
 

REFERENCES
1. Casley-Smith J.R. and Casley-Smith Judith R.: "High-Protein Oedemas and Benzo-Pyrones". J. B. Lippincott. Sidney. 1986.
2. Clodius, Leo: "Diagnóstico y tratamiento de los linfedemas". (Coordinador: Jiménez Cossío).Lab. Uriach, Madrid. 1987.
3. Fóldi, M.: "Lymphedema: past, present and future". Proceedings of the IXth International Congress of Lymphology. Tel Aviv, 1983; 117-123.
4. Fbldi, M., Fóldi, E.: Lectures given in the I and II International Simposium on Lymphedema. Buenos Aires, Argentina. 1988-1990.
5. Grandval, C.: Lectures given in the Universidad Católica Argentina.
6. Nieto, S.: "Linfedema secundario: su tratamiento médico". Premio Elio Craven 1988. Buenos Aires, Argentina.