Articles

SUCCESSFUL MULTI-MODAL TREATMENT OF GRADE IV LYMPHEDEMA IN LYMPHATIC FILARIASIS: A CASE STUDY

Authors: R Sivaprakasam ( ) , R Anuradha ( ) , R Bethunaickan ( ) , G Manokaran ( )

Abstract

We present an integrated therapeutic approach performed on a 37 year old female with giant lymphedema (Grade IV) due to lymphatic filariasis of 27 years duration. Our therapeutic approaches consisted of a basic foot care program for two weeks, followed by a course of oral penicillin for a week including conservative treatment with complete decongestive therapy (CDT) together with respiratory physiotherapy and walking exercises. In addition, advanced surgical techniques with supra-fascial excision of alternate lumps in three stages over an interval of ten days followed by a nodo-venal shunt resulted in reversing the stage IV lymphedema condition. Over a ten year followup, the patient remains essentially unchanged confirming the success of the treatment without any recurrence or complications. Finally, by combining multimodal treatment, we were able to achieve a near normal limb in Stage III and Stage IV lymphedema of the lower limb in lymphatic filariasis.

Keywords: lymphedema, treatment, nodo-venal shunt, MLD

How to Cite: Sivaprakasam, R. , Anuradha, R. , Bethunaickan, R. & Manokaran, G. (2018) “SUCCESSFUL MULTI-MODAL TREATMENT OF GRADE IV LYMPHEDEMA IN LYMPHATIC FILARIASIS: A CASE STUDY”, Lymphology. 51(2).