Physiopathological Hypothesis of Cellulite

A series of questions are asked concerning this condition including as regards to its name, the consensus about the histopathological findings, physiological hypothesis and treatment of the disease. We established a hypothesis for cellulite and confirmed that the clinical response is compatible with this hypothesis. Hence this novel approach brings a modern physiological concept with physiopathologic basis and clinical proof of the hypothesis. We emphasize that the choice of patient, correct diagnosis of cellulite and the technique employed are fundamental to success

Lipoedema and varicose vein surgery: a worse prognosis?

The case of a 22-year-old patient who suffered from lipoedema of the lower limbs and underwent aesthetic surgery for varicose veins is reported. After surgery the patient started to present a sensation of heaviness, oedema and tiredness of the limbs. It was observed that the haematomas took about eight months to disappear. The diameter of the legs increased by 4 centimetres in this period. The aim of this publication is to warn about this happening in patients suffering from lipoedema who are then submitted to varicose vein surgery.The case of a 22-year-old patient who suffered from lipoedema of the lower limbs and underwent aesthetic surgery for varicose veins is reported. After surgery the patient started to present a sensation of heaviness, oedema and tiredness of the limbs. It was observed that the haematomas took about eight months to disappear. The diameter of the legs increased by 4 centimetres in this period. The aim of this publication is to warn about this happening in patients suffering from lipoedema who are then submitted to varicose vein surgery

Dynamic evaluation of venous pressure gradients comparing walking and bending and stretching of the foot and toes

Background. The objective of the current study was to evaluate variations in the venous pressure gradient during walking and bending and stretching of the foot and toes in physiological situations. Material and methods. The medial vein of the big toe of a volunteer was punctured and an Angiocat catheter was inserted connected to a DTX Sensor Plus TM. This portable device measures blood pressure at half-second intervals and stores the data in the form of numbers. The venous pressure gradients were measured for two to three minutes in 10 experiments for each type of exercise: walking and bending and stretching of the foot and toes. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value < 0.05) considered acceptable. Results. Walking exerts higher venous pressure differences than bending and stretching of the foot or of the toes. Conclusions. In conclusion, walking and movements of the joints of the foot and toes cause a pulsating flow which is important to overcome gravitational pressure while standing.Background. The objective of the current study was to evaluate variations in the venous pressure gradient during walking and bending and stretching of the foot and toes in physiological situations. Material and methods. The medial vein of the big toe of a volunteer was punctured and an Angiocat catheter was inserted connected to a DTX Sensor Plus TM. This portable device measures blood pressure at half-second intervals and stores the data in the form of numbers. The venous pressure gradients were measured for two to three minutes in 10 experiments for each type of exercise: walking and bending and stretching of the foot and toes. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value < 0.05) considered acceptable. Results. Walking exerts higher venous pressure differences than bending and stretching of the foot or of the toes. Conclusions. In conclusion, walking and movements of the joints of the foot and toes cause a pulsating flow which is important to overcome gravitational pressure while standing

Surgical treatment of elephantiasis of the feet in congenital lymphedema to facilitate the use of a compression mechanism

The aim of the current study is to report on the minimal surgical treatment of elephantiasis of the feet to facilitate the use of compression mechanisms. The cases of two patients with congenital lymphedema that evolved to elephantiasis involving the feet are reported. Intensive treatment of the lymphedema was performed with a significant reduction in size thus allowing a better identification of the limits of tissue masses for the surgical approach. This reduction enabled primary suturing of the lesions to be carried out and fast healing of the wounds. The surgery greatly improved large deformities of the toes and feet and facilitated further treatment of the lymphedema using bandaging. Thus, the skin was preserved, there was a reduction in the size of the feet, and the patients were able to start wearing shoes

Lipo-lymphoedema and idiopathic cyclic oedema

The case of a 56-year-old patient suffering from morbid obesity associated with lymphoedema of the lower limbs is reported. A clinical diagnosis of idiopathic cyclic oedema and stage II lipo-lymphoedema was made, characterized by hardened oedema which was irreversible during resting, and the presence of varicosities in the lower medial third of the limbs. The limb circumferences were measured. Lymphatic drainage was chosen as treatment for 15 days, which led to a reduction in the circumference of the limb. After this, the patient missed treatment for about 15 days and again presented with an increase of the oedema, but this increase improved with rest. An Unna boot was chosen due to the difficulty of using contention stockings or bandages. The association of the Unna boot accelerated the reduction of the oedema. In conclusion, the differentiation between lipoedema and lipo-lymphoedema is difficult, so a successful treatment was achieved with the association of several therapies, including the use of a multidisciplinary healthcare team.The case of a 56-year-old patient suffering from morbid obesity associated with lymphoedema of the lower limbs is reported. A clinical diagnosis of idiopathic cyclic oedema and stage II lipo-lymphoedema was made, characterized by hardened oedema which was irreversible during resting, and the presence of varicosities in the lower medial third of the limbs. The limb circumferences were measured. Lymphatic drainage was chosen as treatment for 15 days, which led to a reduction in the circumference of the limb. After this, the patient missed treatment for about 15 days and again presented with an increase of the oedema, but this increase improved with rest. An Unna boot was chosen due to the difficulty of using contention stockings or bandages. The association of the Unna boot accelerated the reduction of the oedema. In conclusion, the differentiation between lipoedema and lipo-lymphoedema is difficult, so a successful treatment was achieved with the association of several therapies, including the use of a multidisciplinary healthcare team

Hospital infection after major amputations

The aim of the current study was to evaluate the prevalence of stump infections after major amputations of the lower extremities