Management of ulcers in lymphoedematous limbs

Lymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or...

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Main Author: Vishnu M. Karnasula
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2012-05-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.101291
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author Vishnu M. Karnasula
author_facet Vishnu M. Karnasula
author_sort Vishnu M. Karnasula
collection DOAJ
description Lymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or worsen. Ulcers in lymphoedema patients, therefore, represent not only a medical but also a psychological problem. The treatment is often regarded as being worse than it actually is. In our study of more than 25 years shows around 10% cases are due to chronic lymphodema. Ulcers of chronic lymphoedema are classified into four stages according to their presentation. Their management depends upon their stage of presentation. Patients with chronic lymphoedema and ulceration require a different approach to treatment. The specific issues associated with managing the patient with lymphoedematous ulceration include, limb shape distortion i.e., elephantiasis, care of the skin creases and folds, and swelling of the toes and fore foot. Stage I ulcers will heal with conservative treatment without any surgical intervention. Stage II ulcers needs debridement of the wound and split-thickness skin grafting. The most difficult to treat are the stage III and IV ulcers, due to associated skin changes and reduced vascularity. These cases need debulking along with excision of the ulcer. In order to prevent recurrence of the ulcer in all the four stages needs prolonged follow-up and limb care.
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spelling doaj-art-340c3cd7fcec44b0afe84e527dddd9832025-08-20T02:24:15ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2012-05-01450226126510.4103/0970-0358.101291Management of ulcers in lymphoedematous limbsVishnu M. Karnasula0Department of Plastic Surgery, G.S.L. Medical College, Rajahmundry, Andhra Pradesh, IndiaLymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or worsen. Ulcers in lymphoedema patients, therefore, represent not only a medical but also a psychological problem. The treatment is often regarded as being worse than it actually is. In our study of more than 25 years shows around 10% cases are due to chronic lymphodema. Ulcers of chronic lymphoedema are classified into four stages according to their presentation. Their management depends upon their stage of presentation. Patients with chronic lymphoedema and ulceration require a different approach to treatment. The specific issues associated with managing the patient with lymphoedematous ulceration include, limb shape distortion i.e., elephantiasis, care of the skin creases and folds, and swelling of the toes and fore foot. Stage I ulcers will heal with conservative treatment without any surgical intervention. Stage II ulcers needs debridement of the wound and split-thickness skin grafting. The most difficult to treat are the stage III and IV ulcers, due to associated skin changes and reduced vascularity. These cases need debulking along with excision of the ulcer. In order to prevent recurrence of the ulcer in all the four stages needs prolonged follow-up and limb care.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.101291lymphoedemanodo-venous shuntomentumulcer leg
spellingShingle Vishnu M. Karnasula
Management of ulcers in lymphoedematous limbs
Indian Journal of Plastic Surgery
lymphoedema
nodo-venous shunt
omentum
ulcer leg
title Management of ulcers in lymphoedematous limbs
title_full Management of ulcers in lymphoedematous limbs
title_fullStr Management of ulcers in lymphoedematous limbs
title_full_unstemmed Management of ulcers in lymphoedematous limbs
title_short Management of ulcers in lymphoedematous limbs
title_sort management of ulcers in lymphoedematous limbs
topic lymphoedema
nodo-venous shunt
omentum
ulcer leg
url http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.101291
work_keys_str_mv AT vishnumkarnasula managementofulcersinlymphoedematouslimbs