Conference "Lymphedema, venous edema and ulcers. New methods of treating old problems ", Moscow, 17.11.2017.
17 November in Moscow a conference with international participation was held with the support of MEDI (Germany) and SERVIER (France).
One of the leading European specialists in the field of lymphology and phlebology, the head of the "Opt" Clinic for Lymphology took part in the conference. Franz-Josef Schingale (Germany).
Head of the phlebology center "MIFTS", Ph.D. Semenov A.Yu. and the leading specialist of the clinic on lymphedema, lymphologist Malakhov A.M. were directly involved in the conference.
Head of the phlebology center "MIFTS" Semenov A.Yu. at the conference
The President of the Association of Phlebologists of Russia, Professor, Doctor of Medical Sciences Stoyko Yuri Mikhailovich, greeted participants of the conference with a welcoming speech.
Welcome address of the President of AFR, Professor, MD. Stojko Yu.M.
The first report of Dr. Franz Josef Shingale was called: "Edema of the lower extremities: from accurate diagnosis to effective treatment."
Speaker Dr. Dr. Franz-Josef Schingale (Germany)
In his report, the doctor dwelled in detail on the epidemiology of edematous syndrome. Here, in his opinion, the main causes of the development of edema of the lower extremities:
- Venous edema: thromboses and CVI (chronic venous insufficiency);
- Lymphogenous edema: primary and secondary;
- Lipoid edema;
- Hypodynamic edema;
- Hypoproteinemic edema: nephropathy, enteropathy, carcinomatosis, famine, burns;
- Infectious edema: bacteriological, allergic, traumatic, rheumatic;
- Other types of edema: drug, neurogenic, toxic, hormonal, cardiogenic edema
First of all, it is necessary to understand: what is the swelling of the lower extremities?
Edema (from the Greek - edema, "swelling") is a pathological accumulation of fluid in the interstitial tissues located in the subcutaneous tissues and in the body cavities. The amount of interstitial fluid is due to the balance of fluid hemostasis. The cause of this condition can be both increased fluid flow from the interstitial tissue, and the difficulty of its outflow.
On his slides, Dr. Shingale described in some detail patients with primary and secondary lymphedema.
Patients with primary lymphedema
Patients with secondary lymphedema
Then Dr. Shingale stopped on the diagnosis of lymphedema. In his opinion, the most important criteria for diagnosis are careful collection of anamnesis and examination of the patient. When examining all patients, it is necessary to check the symptom of Stemmer and the measurement of subcutaneous adipose tissue. In his clinic to all patients, he conducts pyrometrics upon admission and, accordingly, at discharge. Special examination methods include ultrasound scanning of the veins of the lower extremities, lymphoscintigraphy, indirect lymphography, computed tomography, magnetic resonance imaging and the fluorescence method of investigation.
Specially, a patient suffering from lymphedema was invited to the conference. Dr. Shingale independently collected an anamnesis and conducted a survey.
Dr. Shingale is conducting a patient examination
The next report, "Adjustable Inextensible Compression Bandages Circaid (RNB) - a revolutionary approach to the treatment of edema," made the director of development of Medi Igor Valentinovich Artyukh.
Reports by IV Artyukh
He stressed the importance of the classification of compression knitwear according to ICC (International Compressional Club). Since comparing the two compressive materials with the same resting pressure, less stretch material will have a higher working pressure. This effect was used in the production of the newest inextensible compression bandage called Circaid.
What is a Circaid?
Circaid is an adjustable inextensible compression knitwear consisting of a patented Breathe-O-Prene material, which creates a rigid compression for 24 hours, breathable, comfortable and pleasant for the skin. Also this material has antimicrobial properties, which prevents the appearance of an unpleasant odor.
Circaid is used to treat patients with lymphedema.
Indications for the purpose of this jersey are:
- Inability to use conventional compression knitwear.
- The need for compression therapy at night.
- Treatment of lymphedema in combination with knitted fabrics.
The main ideas and advantages of Circaid knitwear
Another know-how of this jersey is the patented BPS-Built-In Pressure System, which allows you to set and monitor the therapeutic level and pressure gradient during the day.
The next report is "Servier. Leadership. Partnership. High standards "made the medical representative of the company" Servier "Ekaterina Erina.
Reported by the representative of the company "SERVIE" E. Erina
She spoke about the company's development in the world and its current achievements in Russia. In particular, the company was awarded the Platinum Ounce Prize and took the lead in selling Detralex.
Next report Franz-Josef Schingale from Germany was dedicated to compression therapy for lymphedema. It was called: "Compression with lymphedema is the basis of complex therapy"
Speaker Franz-Josef Schingale from Germany
In his practice, Dr. Shingale uses two-phase therapy, or the so-called "Feldi System." In the first phase, treatment is aimed at reducing edema. In this phase, manual lymph drainage massage, bandage of the limb, treatment of skin manifestations of the disease and physical exercises are used. In the second phase, supporting, the bandage is replaced by compressive knitwear of circular knitting.
What does Dr. Shingale think is optimal lymphatic therapy?
In order to achieve the best possible results of treatment, it is necessary to carry out a serious set of measures, which includes:
- Manual lymph drainage massage performed by trained specialists
- Proper banding of the limb
- Constant exercise
- Proper nutrition
- Most importantly - the patient's motivation to achieve results.
Banding is a major part of decongestant therapy. It reduces edema, reduces the shape of the limb, protects the skin and reduces the symptoms of chronic lymphovenous insufficiency. When banding a limb, it is necessary to use the entire arsenal, which is available from a specialist in the lymphology. Bandages of short and ultrashort extensibility, lymphatic teips and, of course, various types of compression knitwear.
Results of treatment of lymphedema of lower extremities
Results of treatment of lymphedema of the upper limb
In his last report: "Flebolimphedema: A Forgotten Problem of Routine Clinical Practice?" Dr. Shingale demonstrated the tremendous results of treatment for patients with lymphedema in his clinic.
Results of treatment of the patient in the clinic of Dr. Shingale
In conclusion, Dr. Franz-Josef Schingale (Germany) kindly answered all questions of Russian phlebology.
Dr. F. Shingale answers questions
A particularly pleasant moment of the conference was the meeting of phlebologists who visited the Optology Lymphology Clinic in the German city of Bayrot in 2015.
Dr. Franz-Josef Schingale (Germany) with Russian phlebologists from Moscow (Semenov A.Yu.), St. Petersburg (Chernykh KP), Kazan (Malyshev KV), Ekaterinburg (Osipova E.) and Tyumen (Murzina E.)