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Italy: compression in cases of lipedema and lymphedema Custom-made products for more quality of life

Issue 03/2021

Treating patients with lipedema and lymphedema requires sensitivity and expertise. In a self-payer market, such as Italy, the quality of both the product and advice are crucial, as Cinzia Zagaria is well aware. She has been consulting and treating patients suffering from edematous conditions for 40 years in a specialist medical retail store.

“They are strong women, real fighters,” says Cinzia Zagaria from Turin in Italy about her customers with lipedema and lymphedema, “they are very determined to deal with their situation.” Cinzia Zagaria has been working in the area of compression products for more than 40 years. She has looked after around 4,500 patients in this time and witnessed a good deal of change. For her – as well as for her patients – the most important technical product development was the switch from circular-knit to flat-knit compression stockings in the mid-1990s. But changes also take place in patients. “In recent years, Italy has seen a steady increase in lipedema and lymphedema. Plus, patients are younger these days, more often between the ages of 40 and 60,” Cinzia Zagaria reports. “More and more, this brings these conditions to the public’s attention in Italy, too. Patient advocacy groups, such as ‘SOS lymphedema’ and ‘LIO – Lipedema Italia Onlus’ have increasingly come to the fore, and physicians address these conditions more frequently now.” This results in practical improvements for those affected. An interdisciplinary approach is used, with specialist treatment centers that combine kinesiotherapy, diet and manual lymphatic drainage. “Physical therapists are crucial in this process,” says Cinzia, on the base of her high experience, “their cooperation with orthotists will result in the best solution for the patient.”  

Expert advisor with many years of experience: Cinzia Zagaria.
Expert advisor with many years of experience: Cinzia Zagaria.

Providing products is a precision job

Cinzia Zagaria knows the entire spectrum that edema patients present – be it an early stage just after surgery, primary lymphedema in children or patients with a condition that has been manifesting for more than 20 years. In each case, the challenge is to measure the patient as accurately as possible. Cinzia Zagaria learned the lymphological measurement technique in Germany. She has spent time with Angela Vollmer, an expert orthopedic technician at Feldbergklinik hospital in the Black Forest, who, in turn has worked for Prof. Michael Foeldi at Foeldiklinik hospital for a long time. After measuring, the appropriate product needs to be selected: it must equally be therapeutically effective as well as promoting compliance. “Actually, I recently had a look,” says the consultant, “for new products that combine effectiveness and comfort. That’s when I discovered VenoTrain curaflow. I’m thrilled and – more importantly – my patients tell me that the product is excellent.”

Feeling fresh, thanks to microfibers

A 30-year-old woman with secondary lymphedema was treated after removal of a tumor.
A 30-year-old woman with secondary lymphedema was treated after removal of a tumor.

Even after just about a year, the medical product expert cannot imagine her compression product portfolio without VenoTrain curaflow. “I now treat most of my patients with this product because the material is like a second skin to them, it’s soft and remains securely in position. They particularly appreciate that no additional silicone inserts are needed to keep the compression stockings where it needs to be.” And there is another aspect that Cinzia Zagaria would like to emphasize: the high microfiber content of the knitted fabric. It counteracts the development of heat and moisture under the stocking. “My patients who suffer from chronic edema wear compression products permanently, even during Italy’s summer heat. That means the product’s wearing comfort and a feeling of freshness are particularly important for the patient’s quality of life.”

The specific product properties not only help with patient compliance, but they also promote their willingness to pay a little more for a good product. Essentially, Italy is a self-payer market with only a few options for reimbursement – and this varies in different regions. Only the Region Trentino-Alto Adige supports patients suffering by venous or lymphatic disease with two stockings per year. That is why patients in Italy wear their compression products much longer than the six months recommended by the manufacturers. Cinzia Zagaria therefore takes her time when first fitting her patients to provide an in-depth consultation about putting on and taking off the products as well as caring for them.

Embracing color

Expert advice and high-quality products are crucial aspects for customers in Italy – and there is something else. “My patients love color! Less so for arm sleeves, they prefer subtle, skin-colored shades there. But for stockings, they want a good selection of colors. Current favorites are navy and anthracite.” Looks are more than just superficial vanity. “Women with lipedema in particular,” explains Cinzia Zagaria, “find it hard to accept their appearance. And for a long time, lipedema was merely seen as an aesthetic problem, rather than a medical condition. This change in awareness has only happened recently.”

Images: Zagaria


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