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Lymphedema treatment in Austria Looking at the whole patient

Issue 01/2021

Primarily patients suffering from leg lymphedema are being treated in the Lymphology Department at Wolfsberg State Hospital. Holistic study of the patient and close cooperation with the orthopedic technician help to make treatment a success. Since early 2020, the VenoTrain curaflow flat knit compression stocking has been used for compression treatment.
Thanks to its pleasant feel, it is widely accepted by patients.

Wolfsberg State Hospital has been treating patients for more than 140 years. This includes the Lymphology Department on-site, where acute treatment and rehabilitation of conditions related to the lymphatic system take place.
Prim. Dr. Christian Ure, Department Manager at Wolfsberg Lymphology Hospital in Austria.

As the only lymphology department in Austria, Wolfsberg Lymphology Hospital in Kärnten offers acute treatment of lymphedema patients as well as their rehabilitation. Primary and secondary lymphedema as well as angiodysplasia are diagnosed and treated. The unique combination of acute treatment and rehabilitation represents the lymph hospital’s philosophy: when treating patients, it focuses on the bio-psycho-social model that describes the connection between body and mind. According to this holistic understanding, illness and health are not static conditions but dynamic processes. “It’s a misconception to believe you could only treat the edema,” points out Prim. Dr. Christian Ure, Department Manager at Wolfsberg Lymphology Hospital. “Looking at the whole patient and thoroughly evaluating the personal circumstances are always the prerequisites for successful treatment. The rehabilitation process, as it’s pursued in our hospital, follows the same holistic approach.”

Two-stage treatment

Every year, about 1,000 patients are rehabilitated at Wolfsberg Lymphology Hospital. The majority is from Austria. However, sometimes patients from neighboring countries like Italy or Slovenia, but also from further away, come for inpatient rehabilitation. About 60 percent of patients suffer from leg lymphedema and generally arrive once they have reached the advanced stage 2, as well as the severe, deforming stage 3. In stage 2, the swelling becomes considerably harder and the edema does go back, even after extended periods of rest. Swelling in stage 3 patients is extreme. The skin is hard and characterized by warty growths. If this is coupled with complications typically associated with lymphedema, such as erysipelas or comorbidities like heart failure or severe venous disorders, patients will be pretreated with acute care. After that, the actual lymphological rehabilitation starts with complex decongestive therapy (CDT). Its main objective is to reduce the lymphedema to a lower stage – ideally to the patient being free from edema with a normal leg volume. “The treatment takes three weeks and consists of two phases,” Prim. Dr. Christian Ure explains. “Phase 1 is intended to reduce the edema and to loosen the fibrosis. It also includes compression bandaging, decongestive exercises as well as education and help with self-management.” At the end of this first phase, the patient leaves the hospital with custom-made compression garments. “The subsequent second phase, the maintenance and optimization phase, is about stabilizing and preserving the treatment success. True to our hospital’s philosophy, we provide practical training to our patients during their rehabilitation visits to empower them be their own therapists,” Prim. Dr. Christian Ure says.

“It’s a misconception to believe you could only treat the edema.
Looking at the individual and their personal circumstances is a prerequisite for treatment success.”

Prim. Dr. Christian Ure

The maierhofer team knows all about the benefits of the VenoTrain curaflow’s functional details for the treatment of patients suffering from lymphedema.

Comfortable microfibers

Compression stockings play a very special role at Wolfsberg Lymphology Hospital when it comes to treatment with compression. “99 percent of our lymphological patients are provided with custom-made, flat knit compression garments,” Prim. Dr. Christian Ure reports. “Our goal is therefore to have the widest range of all the different compression stockings to ensure we can provide the best possible treatment and the most suitable model for each individual patient – from the youthful sporty type to the older, immobile and overweight patient.” In early 2020, the VenoTrain curaflow has been added to the compression stocking portfolio. One key reason for this is its material: “The microfiber it’s made of is very pleasant to the touch. The stocking feels warm and soft, and triggers a positive reaction even when patients first touch it. The effect that a patient likes and accepts a product is very important and will determine the treatment success, together with the fit and manufacturing quality,” Prim. Dr. Christian Ure reckons.

Sonja Six, Orthopedic Technician at maierhofer lymphologie, affiliated to Wolfsberg Lymphology Hospital.

The perfect introduction

Sonja Six, orthopedic technician at maierhofer lymphologie, also notices that patients respond very positively to the VenoTrain curaflow right from the beginning. The medical supply retailer with five employees is directly affiliated to the hospital, supporting numerous patients. “The VenoTrain curaflow has a special texture that practically all patients notice immediately as very attractive. Compared with other products, this compression stocking makes the introduction to this type of treatment much easier for patients,” Sonja Six points out. “Furthermore, the stocking’s effect on the patient is exceptionally efficient, it offers stability and fits perfectly.This is confirmed regularly by the many positive comments from our patients.” In Sonja Six’ opinion, the functional details provide additional benefits: the flat knit compression stocking is the only one in the maierhofer product range to feature extra flat seams. The VenoTrain curaflow is available in different toe versions, with a 90° heel and toe caps with or without seam. “The special functional zone on the instep is particularly helpful. It can be flexibly extended and therefore helps to compensate for extreme volume changes that are so typical for lymphological conditions and that are otherwise difficult to treat,” the experienced orthopedic technician explains. She also values the great cooperation with Bauerfeind in Austria. “We’re always under time pressure because patient appointments are very close together. Bauerfeind has proven to be a trustworthy partner we can rely on.” The active exchange with the Bauerfeind field sales representatives is a huge advantage for her. “They are proactive in their approach and help without us even having to specially ask. And if a complaint does have to be processed on the odd occasion, it’s really quick and uncomplicated.”

“Our goal is to encourage and motivate patients to empower them
to handle the product themselves.”

Sonja Six

Targeted education

Usually, patients already get in touch with maierhofer lymphologie during their first week of staying at the Lymphology Hospital. During an informational conversation, the medical supply retailer explains the steps of supplying compression products and which appointments they can expect during their inpatient hospital stay. A second appointment takes place about a week before patients are discharged. Specialists then take measurements and order the product. It generally takes two to three days for the ordered products to be delivered. The patient can then be provided with the garments right on time during the third appointment one day before leaving the hospital. On that day, the patient is handed the compression stocking and instructed on how to put it on correctly. “Our goal is to encourage and motivate patients to empower them to handle the product themselves. That’s very easy with the VenoTrain curaflow.” The treating physician also examines and checks the compression product. After that, the fourth and final appointment takes place at maierhofer lymphologie on the day of the patient’s discharge. The orthopedic technicians check the product one more time, ask the patient for feedback and give tips on everyday use and care.

With the VenoTrain curaflow products for the arm, leg and thorax, Bauerfeind offers different garments in various designs to treat edema. They allow a targeted reduction of painful tension, help with the removal of fluid from the tissue and counteract further accumulations and hardening.

A positive interim result

Even if the first comprehensive data evaluation is still ongoing in Wolfsberg, initial trends can already be recognized: “The VenoTrain curaflow is a very good solution for the compression-based treatment of leg lymphedema. This has been repeatedly tried and tested,” Sonja Six summarizes. From a physician’s point of view, the conclusion is as follows: “We can see that, thanks to stocking’s microfiber content, the VenoTrain curaflow is highly suitable for active patients who are still physically agile,” Prim. Dr. Christian Ure concludes.

 

Images: Landeskrankenhaus Wolfsberg/Bruno Klomfar/Gernot Gleiss, Bauerfeind, maierhofer GmbH/Lina Verdel


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