Primary Lymphedema

The following photographs illustrate the presentation of a unilateral primary lymphedema. This particular individual had her lymphedema suddenly onset around 12 years of age after being bite by a mosquito while travelling in the Middle East. Her parents were unable to get a proper diagnosis until she was 18 years of age. Initially it was diagnosed as filariasis more commonly known as elephantiasis. It was not until some years after that she was properly diagnosed with primary lymphedema.

Between August 2002 and July 2009 this individual was treated with repeated sessions of Combined Decongestive Therapy that were successful in reducing her volume to within 600 ml of her unaffected limb volume. She continued to manage the lymphedema with regular manual lymphatic drainage, compression garments and exercise. During this time however she experienced a number of bouts of cellulitis and one open wound that required excising.

In 2009 we arranged for her to be treated at the Wittlinger Clinic in Walchsee, Austria on the condition that they arrange an appointment with Dr. Baumeister, a leading edge surgeon in Munich, Germany.   At the time Dr. Baumeister had recently begun performing microsurgery to transplant lymphatic vessels from the unaffected limb to the affected limb for the treatment of lymphedema.

Following an appointment with him and a number of tests it was determined that she was eligible for the microsurgical procedure. After another year of treatment in Edmonton she returned to Munich and had two lymphatic vessels transplanted from her right leg to her left leg. Following the surgery she returned to Canada where we measured her limb volume every 4 weeks for approximately 14 months. No MLD treatment was performed although she continued to wear compression garments during that time.

During the 14 months her limb volume reduced approximately 2 litres without treatment. She then returned to Munich where Dr. Baumeister performed a debulking procedure to remove excess fat that had accumulated in her affected leg since the onset of the lymphedema.

The following photograph was then in 2012 approximately 6 months after the debulking surgery.

Secondary Lymphedema

The following photo was taken of this client in May 2009 after being discharged from the hospital following a vehicle running over her left leg and pelvis. The leg sustained a crush injury with considerable abrasions and edema.

She began receiving Combined Decongestive Therapy in July 2009 as her left leg remained approximately 400 ml larger than her unaffected right leg. Elevation and compression were not effective in reducing the volume.

Following a 10 day Combined Decongestive Therapy series her left leg volume returned to normal size. She continues to receive regular manual lymphatic drainage to manage her lymphedema and wears compression on occasions when her limb maybe stress or the presence of edema becomes evident.