As the temperature rises, the circumference of legs and ankles increases. Swelling, heaviness, and, in some cases, even annoying tingling sensations afflict 1 out of 2 women in the summer, which is three times more than in winter. Men are not immune either, although they tend to ignore and underestimate the problem more than women. 

SWOLLEN LEGS:

Warning against the risk of lymphedema, especially in what could be the hottest summer ever, is Corrado Campisi, the President of the World Lymphology Congress to be held in Genoa from September 11th to 15th, and a professor of Plastic Surgery at the University of Catania. This event, bringing together doctors, surgeons, nurses, physiotherapists, podiatrists, and many other specialists from around the world, represents an opportunity for updates on the treatment of lymphatic disorders and discussions on the latest technological advancements. 

“When we talk about swollen legs and circulation, we often think of blood flowing through our arteries and veins driven by the heart,” explains Campisi, one of the foremost specialists in Lymphatic System Surgery and Microsurgery, and co-founder of the Campisi Clinic. “However, in addition to the major ‘highways’ of the circulatory system, consisting of arteries, veins, and capillaries, there is also an intricate network represented by the lymphatic system that transports proteins, fluids, and lipids.

This system, made up of lymphatic vessels and lymph nodes, allows lymph to be drained into body tissues throughout our body before it returns to the bloodstream. Malfunctions in this network can lead to abnormal swelling of hands, arms, or legs, sometimes so extensive that they resemble ‘elephant limbs.'” 

There are two main forms of lymphedema: “primary,” resulting from congenital malformations of the lymphatic system’s vessels, and “secondary,” caused by external adverse events that disrupt the normal functioning of the lymphatic system, such as lymph node removal and radiation therapy, both of which are part of cancer treatments. It is estimated that there are 350 million people with lymphedema worldwide, with 2 million in Italy alone. These numbers are rapidly increasing, with approximately 40,000 new cases per year in Italy. 

“When anomalies occur in the lymphatic circulation of our legs, there is an accumulation of fluids in the tissues. When this condition, as often happens, is combined with venous circulation insufficiency in the limbs, the situation becomes even more complex,” Campisi emphasizes. “It’s not just an aesthetic problem, though aesthetics are significant because during the summer, walking or even wearing shoes can become difficult. Fluids that cannot be drained may become so dense, due to their high protein content, that they can compromise proper tissue oxygenation, leading to redness, eczema, dermatitis, ulcers, and infections.” 

The good news is that risks can be reduced by preventing complications. There are various levels of treatment depending on the severity of lymphedema, ranging from simple lifestyle changes to medications, physiotherapy, or even minimally invasive surgery. “Timely diagnosis of the problem makes all the difference, and it can only be achieved by recognizing the early warning signs,” suggests the specialist.

“Initially, symptoms may be subtle and hard to detect in summer, with the most common being leg heaviness and swollen ankles, often mistakenly considered ‘normal’ and thus ignored. However, what cannot be ignored is the difficulty in reducing leg swelling. If elevating the legs and cooling them with cold water doesn’t provide relief, it’s advisable to consult a specialist.” 

For the doctor, initially, just one finger is enough to check for a problem. “Applying pressure with a finger on the ankle or leg can reveal the formation of a kind of dimple for a few seconds, a clear sign of lymphatic dysfunction,” says Campisi. “Clinical observation should also be supplemented with an EcoColorDoppler to study venous circulation and a lymphoscintigraphy to check for lymphatic blockages.” 

At that point, there are various levels of treatment: from simple lifestyle changes such as avoiding smoking or prolonged standing to wearing compression stockings that gradually drain fluids from the ankle upwards. There’s also pharmacological therapy with drugs like benzopyrones, antibiotics, antifungals, diethylcarbamazine, and diuretics, along with manual lymphatic drainage by a specialized physiotherapist, mechanical drainage using devices like pneumatic compression, or the use of multi-layer bandages and exercises. 

A much more recent approach is microsurgery, which can address lymphatic blockages directly, thus preventing recurrences. “The surgical procedures available for lymphedema treatment are diverse,” Campisi explains. “They range from lymphaticovenous bypasses designed to create a peripheral physiological drainage to autologous tissue and lymph node transplants to establish a new lymphatic drainage system in the affected limb, and even ultrasound-guided liposuction as a way to ‘unclog’ the lymphatic blockages and facilitate surgical procedures. During the ISL congress, specialists will have the opportunity to discuss the latest microsurgical techniques on the lymphatic system.” 

In the meantime, in preparation for summer, experts have compiled a list of ten tips to “lighten” swollen legs: 

Source: IMG PRESS  

Source: SALUTE DOMANI

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