Rome, June 26. (Adnkronos Health) – When temperatures rise, so does the circumference of the legs and ankles. Swelling, heaviness, and sometimes an annoying tingling sensation “which, in summer, affects as many as 1 in 2 women, three times more than in winter. Men are not immune, though they tend to ignore and underestimate the problem more than women do.”

SOS FOR SWOLLEN LEGS IN 1 OUT OF 2 WOMEN:

Warning of the risk of lymphedema, especially in what might be the hottest summer ever, is Corrado Campisi, President of the World Congress of Lymphology to be held in Genoa from September 11 to 15, and Professor of Plastic Surgery at the University of Catania. The event, bringing together doctors, surgeons, nurses, physiotherapists, podiatrists, and many other specialists from around the world, represents an opportunity to update on the treatment of lymphatic pathologies and discuss the latest technological advances. 

“When talking about swollen legs and circulation, the focus often goes directly to blood, which flows through the arteries and veins of our body by the pumping of the heart,” explains Campisi, considered one of the leading specialists in Surgery and Microsurgery of the lymphatic system and co-founder of Campisi Clinic.

“However, in addition to the major ‘highways’ of the blood circulatory system, there is also a complex network represented by the lymphatic system that transports proteins, fluids, and lipids. This system – he continues – made up of lymphatic vessels and nodes, allows lymph to be drained in body tissues, at every point of our body, before joining the blood circulation. A malfunction of this network can lead to abnormal swelling of hands, arms, or legs, sometimes so extensive as to resemble ‘elephant limbs’.” 

Experts have devised a ten-point plan to ‘lighten’ swollen legs in the summer: 1) Engage in regular moderate physical activity. Gradual training is better, without intense efforts to avoid overstraining the limbs; 2) Perform exercises preferably in the morning, when the limb is not yet fatigued from daily routine; 3) Wear comfortable shoes with a 2-2.5 centimeter heel;

4) Avoid walking barefoot, even if it seems to provide immediate relief; 5) Take walks by the sea, with water up to the waist; 6) Do not expose yourself to the sun during the hottest hours. Sunburn can cause inflammation of the lymphatic capillaries; 7) Change position often when sitting or standing for a long time; 8) Sleep with legs slightly raised, placing a pillow under the mattress; 9) Do not cross legs when sitting; 10) On long plane or car journeys, wear elastic stockings and try to move your legs, taking short breaks from sitting. 

There are two main forms of lymphedema: ‘primary’, due to congenital malformations of the lymphatic system vessels, and ‘secondary’, due to external adverse events that alter the normal function of the lymphatic system, such as lymph node removal and radiotherapy, both used in oncological treatments. It is estimated that there are 350 million people with lymphedema worldwide, 2 million in Italy alone. These numbers are rapidly increasing, with about 40,000 more each year in Italy.

Initially, a doctor can detect a problem with just one finger. “By pressing a finger on the ankle or leg, it can be observed that, for a few seconds, a sort of pit forms, a clear sign of lymphatic dysfunction,” says Campisi. “Clinical observation should then be coupled with an EcoColorDoppler for studying the venous circle and lymphoscintigraphy to check for lymphatic blockages.” 

Treatment can range from simple lifestyle changes, such as avoiding smoking or standing still for long periods, to the use of elastic stockings that exert graduated compressive force, draining fluids from the ankle upwards. This is followed by pharmacological therapy with, for example, benzopyrones, antibiotics, antifungals, diethylcarbamazine, diuretics, manual lymphatic drainage with a specialized physiotherapist, mechanical drainage with, for example, pressotherapy, or the use of multilayer bandaging and gymnastic exercises. More recently, microsurgery has been used to directly address the lymphatic blockage, preventing recurrences. 

“The surgical procedures currently available are numerous,” explains Campisi, “ranging from lymphaticovenous bypasses, which create a physiological peripheral discharge to resolve the obstruction, to autologous tissue and/or lymph node transplants to create a new lymphatic drainage system in the affected limb, up to actual lymphatic-guided liposuctions.” The expert is also the creator of a new technique of ‘ultrasound liposuction’, which uses sound waves to ‘dissolve’ lymphatic blockages and facilitate the surgical procedure. At the congress in Genoa, specialists will have the opportunity to discuss the latest microsurgical techniques on the lymphatic system. 

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