They are short-stretch bandages containing a paste of zinc oxide and other active substances (natural coumarins, glycerol, calcium chloride, etc.). They are employed in the treatment of venous disorders – e.g. in postphlebitic syndrome – or in lymphatic disorders, for example in acute and chronic lymphangitis, in particular owing to their anti-inflammatory, antibacterial, exudate-absorbing activity, hence for their trophic effect on tissues involved by irritative-dystrophic processes.
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Although words like lymphocyte, lymph node, lymph, and lymphatic vessels are common in daily medical activities, Lymphology has always been considered as a sort of younger sister to Angiology or Phlebology. Also, apart from few pioneer physicians, it has never been investigated as a discreet, well identified area of research.
Therefore, the following “Dictionary” aims to be a sort of metaphorical “window” on the extensive and still poorly explored world of lymphatic diseases, as well as to provide some useful, basic information for a correct diagnosis of patients affected by lymphatic-lymph node disorders.
BENZOPYRONES
Benzopyrones are a heterogeneous group of chemical substances mostly of plant origin, with a basic structure consisting of a benzenic ring, where an oxygen molecule replaces a carbon one. There are two main classes of benzopyrones: alpha-pyrones (coumarins) and gamma-pyrones (diosmin, hesperidin, rutin).
BPV (PATENT BLUE VIOLET)
From a chemical point of view, BPV is a monosodium salt in methanol used in lymphology as a stain for in vivo detection of lymphatic structures. Owing to its chemical composition, it has a remarkable tropism for lymphatics and, when injected into the tissues, it is almost completely drained through all major lymphatic collectors and structures. It is excreted by the kidneys. In some individuals, it may cause allergic reactions.
CELLULITE
This is the term often used to describe a more common anatomic-clinical picture of EFSP (see EFSP).
CELLULITIS
It is an acute inflammation of the skin, showing the usual semeiotic signs of inflammation: rubor, dolor, calor and tumor. In the majority of cases, it is caused by infection (streptococci), with either mild or even very aggressive clinical pictures. Sometimes, it may even be life-threatening (septic shock).
Fig. Device manufactured by VACUMED for cellulite treatment.
CHARLES OPERATION
Surgery performed in the past to excise lymphedematous tissues with irreversibly damaged structures. This operation, similarly to other “demolishing” surgical approaches in the treatment of lymphedema (e.g. Servelle’s operation, or total surface lymphangectomy, and Thompson’s buried dermal flap operation) was selected for patients with advance stage lymphedema. More exactly, it featured a skin excision (both of the sub-cutis and the fascia – e.g. a cutolipofasciectomy) in the affected anatomic district. Today, these surgical techniques have been totally replaced by new reconstructive microsurgical techniques, which are commonly applied in lymphology. Another reason for becoming obsolete techniques is that, since they only act on secondary effects of lymphatic failure – e.g. imbibition of suprafascial tissues – they have never yielded any encouraging results, neither in the short term – due to severe surgical invasiveness and serious post-operative complications, nor in the long term, due to extensive scarring and disfigurement caused by the operation itself.