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1.
Hautarzt ; 69(8): 662-673, 2018 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-29951853

RESUMO

Under the direction of the German Society of Phlebology (Deutsche Gesellschaft für Phlebologie) and in cooperation with other specialist associations, the S1 guideline on intermittent pneumatic compression (IPC) was adopted in January 2018. It replaces the previous guideline from March 2005. The aim of the guideline is to optimize the indication and therapeutic use of IPC in vascular diseases and edema. An extensive literature search of MEDLINE, existing guidelines, and work relevant to the topic was performed. In view of the often methodologically weak study quality with often small numbers of cases and heterogeneous treatment protocols, recommendations can often only be derived from the available data using good clinical practice/expert consensus. Intermittent pneumatic compression is used for thromboembolism prophylaxis, decongestive therapy for edema, and to positively influence arterial and venous circulation to improve clinical symptoms and accelerate ulcer healing in both the outpatient and inpatient care setting. The therapy regimens and devices used depend on the indication and target location. They can be used as outpatient and inpatient devices as well as at home for long-term indications. A target indication is thrombosis prophylaxis. IPC should be used in severe chronic venous insufficiency (stages C4b to C6), in extremity lymphedema as an add-on therapy and in peripheral arterial occlusive disease (PAOD) with stable intermittent claudication or critical ischemia. IPC can be used in post-traumatic edema, therapy-resistant venous edema, lipedema and hemiplegia with sensory deficits and edema. Absolute and relative contraindications to IPC must be taken into account and risks considered and avoided as far as possible. Adverse events are extremely rare if IPC is used correctly. If the indication and application are correct-also as an add-on therapy-it is a safe and effective treatment method, especially for the treatment of the described vascular diseases and edema as well as thrombosis prophylaxis.


Assuntos
Dispositivos de Compressão Pneumática Intermitente , Tromboembolia , Insuficiência Venosa , Anticoagulantes , Edema , Humanos , Tromboembolia/prevenção & controle , Resultado do Tratamento
2.
Chirurg ; 84(7): 607-16; quiz 617-8, 2013 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-23801103

RESUMO

Swellings of the extremities are often observed in routine practice and are initially seen as a symptom; therefore, it is extremely important to find the cause and often produces differential diagnostic problems. As the diagnosis of lymphedema is mostly a clinical one it is especially necessary to thoroughly investigate an exact anamnesis and clinical examination which should be combined with as little technical equipment as possible. Implementation of the correct and consistent therapy of this chronic disease and continuous surveillance represents a special challenge for physicians and therapists. Operative solutions represent the last resort and often end in unsure results.


Assuntos
Linfedema/etiologia , Linfedema/terapia , Doença Crônica , Comportamento Cooperativo , Diagnóstico Diferencial , Extremidades , Seguimentos , Humanos , Comunicação Interdisciplinar , Linfedema/classificação , Linfedema/diagnóstico , Equipe de Assistência ao Paciente
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