The State-of-the-Art: Building Bridges “Lymphoedema”
26.05.2018 - Gent (Belgium)
“State of the art: building bridges - lymphoedema” - this was the motto of the 3rd International Lymphology Symposium organised by Juzo that took place on 26 May 2018 in Ghent, Belgium. Under the scientific leadership of Robert J. Damstra, MD PhD, Dermatologist at Nij Semllinghe Hospital in Drachten (The Netherlands), together with Julius Zorn GmbH (Germany), a platform was provided for an interdisciplinary knowledge exchange on lymphological topics. Around 180 participants from 16 different countries came to Ghent to listen to and then discuss various specialist lectures. Thanks to simultaneous interpretation, visitors were able to follow English presentations in Dutch and French.
“Building bridges” - bridges of different kinds were the focus of the event, whether between medical treatment aspects and experience or between specialist medical retailers, therapists and doctors from various countries. The programme included new developments in interdisciplinary surgery for lymphoedema as well as new findings in pathophysiology in cases of oedemas and wounds. There were also lectures about the genetic causes of oedemas and the interdisciplinary requirement of conservative therapy.
The event began with Robert J. Damstra, MD PhD, welcoming the numerous visitors. The new model of adaptive therapy is designed to create a clear framework for patients and encourage self-management, with the result that the patient becomes the focus of the treatment, contributing to its positive development. The European Union’s European Reference Networks should provide a platform to experts and centres of expertise from all countries for the exchange of knowledge.
After that, Harry G. J. M. Voesten, MD, Nij Semllinghe Hospital in Drachten (The Netherlands), talked about interdisciplinary reduction surgery in cases of lymphoedema. He showed different operating methods for oedemas in the area of the foot, genitalia and abdomen. Voesten, MD, highlighted that compression always improves the situation and is good for the patient.
Prof. Dr. Nele Devoogdt, KU Leuven/Leuven University (Belgium) discussed aspects of conservative lymphoedema treatment. It is easy to reduce the oedema but difficult to maintain success. She is currently working on a study to improve manual lymphatic drainage. It will include special focus on a specific thumb technique and fluoroscopy-guided manual lymphatic drainage.
Liesbeth Vandermeeren, MD, University Medical Center Sint Pieter in Brussels (Belgium), explained the method of axillary lipofilling. For patients suffering from breast cancer with venous impairment, autologous fat transplantations in the area of the armpit are very promising. After surgery, manual lymphatic drainage as well as compression bandaging should take place as quickly as possible, according to Vendermeeren, MD.
Tanja P. Ručigai, MD Prim., University Medical Centre Ljubljana (Slovenia), discussed the relationship between genetics and lymphoedema. She provided an overview of the different genetic defects in cases of primary lymphoedema. Genetic defects are being studied more and more, which is increasingly important for the future.
To what extent excessive weight affects the lymphatic fluid, was discussed in the presentation given by Robert J. Damstra, MD PhD, scientific leader of this symposium. Excess weight, fat, inflammation and oedema form a cycle that can be counteracted with compression.
According to Tonny Karlsmark, MD PhD, Institut for Klinisk Medicin at Bispebjerg-Frederiksberg Hospital in Copenhagen (Denmark), a low water content in the edges of the wound seems to be essential for the healing process of venous or traumatic ulceration. TDC (Tissue Dielectric Constant) can be used to monitor the effect of compression therapy at the edge of the wound.
Physiotherapy and clinimetrics for the treatment of lymphoedema were the subject of the presentation given by PhD candidate Ad Hendrickx, Dutch Expert Centre for Lymphovascular Medicine in Drachten (The Netherlands) as well as Hanze University of Applied Sciences Groningen (The Netherlands). For chronic illnesses, complications and the development of the conditions are observed during routine visits. Here, it is important to specify who checks what and when.
Denise Hardy, BsC Hons, Kendal Lymphology Centre in Kendal, Cumbria (UK), provided a clear description of the development of lymphoedema treatment in Great Britain. Self-management should be integrated more effectively into traditional therapy because successful results can only be achieved by working together with the patient as a team. In addition to the usual instruments, psychological support and additional instruments, such as Kinesio taping, also play a role during treatment.
The cost effectiveness of manual lymphatic drainage was critically examined in the presentation given by Prof. Dr. Albert Leduc, Prof. Emeritus Vrije Universiteit in Brussels (Belgium), Prof. Dr. Olivier Leduc and Romain Barbieux, MSc. The costs of the lymphoedema treatment would only represent a minor part of the overall health costs. Manual lymphatic drainage is the only aspect of the physical treatment that can be applied to all parts of the body in cases of lymphoedema.
An “Ask the Experts” session took place at the end of the day. The listeners themselves were able to answer questions about the specialist lectures via a portal. The results were subsequently discussed together. During the breaks, symposium participants had the opportunity to attend practical demonstrations of Juzo SoftCompress Compression Rolls and Juzo ACS light compression systems.
Finally, Robert Damstra, MD PhD, Jürgen Gold, authorised representative of Julius Zorn GmbH, and Johan van Dongen, Managing Director Juzo Benelux BV, thanked all speakers.
Prof. Dr. Nele Devoogdt, PT
KU Leuven – University of Leuven
Department of Rehabilitation Sciences
Ad Hendrickx, PhD candidate
Dutch Expert Centre for Lymphovascular
Hanze University of Applied Sciences
Groningen, The Netherlands
Physiotherapy and clinimetrics in the treatment of lymphoedema
Tonny Karlsmark, MD PhD
Institut for Klinisk Medicin
Dietmar J. O. Ulrich, MD PhD
Professor and Chairman
Department of Plastic Surgery
Radboud University Medical Center
Nijmegen, The Netherlands
Liesbeth Vandermeeren, MD
University Medical Center Sint Pieter
Harry G. J. M. Voesten, MD PhD
Nij Smellinghe Hospital
Drachten, The Netherlands