2023-06-26 15:21:34
As the temperature rises, the circumference of the legs and ankles increases. Swelling, heaviness and, in some cases, even an annoying tingling “which, in summer, affects as many as 1 in 2 women, three times as much as in winter. Not even men are immune, even if they tend to ignore and underestimate the problem much more than women do. To warn against the risk of lymphedema, in view of what could be the hottest summer season ever, is Corrado Campisi, president of the World Congress of Lymphology to be held in Genoa from 11 to 15 September, and professor of Plastic Surgery at the University of Catania. The event, which will bring together doctors, surgeons, nurses, physiotherapists, podiatrists and many other specialists from all over the world, represents an opportunity for updating in the treatment of lymphatic pathologies and for discussion on the main technological innovations.
“When we talk about swollen legs and circulation, our thoughts go directly to the blood, which flows through the arteries and veins of our body through the push of the heart – explains Campisi, considered one of the leading specialists in surgery and microsurgery of the lymphatic system and co- founder of the Campisi Clinic – However, in addition to the great ‘highways’ of the blood circulatory system, made up of arteries, veins and capillaries, there is also an intricate network represented by the lymphatic system which transports proteins, liquids and lipids. This system – continues – made up of lymphatic vessels and lymph nodes, it allows the lymph to be drained into the body tissues, in every part of our body, before pouring into the bloodstream.A malfunction of this network can lead to an abnormal swelling of the hands, arms or legs, sometimes so extended that they look like ‘elephant’ limbs”.
Experts have developed a handbook to ‘lighten’ swollen legs in the summer: 1) Carry out regular moderate physical activity. Gradual training is better, without intense efforts so as not to tire the limbs too much; 2) Perform the exercises preferably in the morning, when the limb is not yet tired from the daily routine; 3) Wear comfortable shoes with 2-2.5cm heels; 4) Avoid walking barefoot, even if it seems to give immediate relief; 5) Take walks by the sea, with water up to your waist; 6) Do not expose yourself to the sun during the hot hours. Sunburn can cause inflammation of the lymphatic capillaries; 7) Change position often when sitting or standing for a long time; 8) Sleep with your legs slightly raised, placing a pillow under the mattress; 9) Do not cross your legs when sitting; 10) In case of too long journeys by plane or by car, wear the elastic girdle and try to move your legs by taking short breaks from the sitting position.
There are two main forms of lymphedema. The ‘primary’ ones, due to congenital malformations of the vessels of the lymphatic system, and the ‘secondary’ ones, due to external adverse events that alter the normal function of the lymphatic system, such as the removal of lymph nodes and radiotherapy, both foreseen in oncological treatments . It is estimated that there are 350 million people with lifedema in the world, 2 million in Italy alone. Strongly growing numbers, in our country about 40 thousand more per year. Initially, a single finger is enough for the doctor to verify that there is a problem. “As the pressure exerted by the finger on the ankle or leg can occur that, for a few seconds, a sort of dimple forms, an evident sign of a lymphatic dysfunction – says Campisi -. Clinical observation should therefore also be associated with an EcoColorDoppler for the study of the venous circulation and a lymphoscintigraphy to verify the presence of lymphatic blockages”.
At that point there are various levels of treatment: ranging from simple lifestyle changes, such as avoiding smoking or standing still for a long time, to the use of elastic stockings, which exert a graduated compressive thrust by draining liquids from the ankle upwards. And then pharmacological therapy with for example benzopyrones, antibiotics, antifungals, diethylcarbamazine, diuretics up to manual lymphatic drainage with a specialized physiotherapist, mechanical drainage with for example pressotherapy or the use of multilayer bandages and gymnastic exercises. Much more recent is the use of microsurgery which is able to resolve lymphatic engorgement, acting directly on the cause, thus preventing recurrences.
“There are many surgical procedures currently available – explains Campisi – ranging from lymphatic-venous bypasses, which create a peripheral physiological drain with which to resolve the obstruction, up to autologous transplantation of lymphatic tissue and/or lymph nodes with the aim of creating a new of lymphatic drainage in the affected limb, up to real liposuction guided by lymphatic navigation”. The expert is also the creator of a new ‘ultrasonic liposuction’ technique, which uses sound waves to ‘dissolve’ lymphatic blockages and facilitate the surgical procedure. On the occasion of the congress in Genoa, specialists will have the opportunity to discuss the latest microsurgical techniques on the lymphatic system.
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