Treatment of Lymphedema

Abstract

To the Editor.— In regard to the question asked in Management of Chronic Lymphedema in a Young Man by L. George Hershey, DO (241:1625, 1979), I was distressed with the final answer by David I. Abramson, MD. There is adequate evidence that it takes pressures of between 20 to 30 mm Hg to keep lymphedema under control, and this is similar to work done in the treatment of hypertrophic burn scars. With hypoplastic lymphatic channels, one can anticipate, unless optimum pressure is maintained, that there will be a gradual increase in the size of the areas involved with lymphedema. To the best of my knowledge, there is no evidence that furosemide (Lasix) really helps in the management of secondary lymphedema as it relates to aplastic or hypoplastic lymphatic channels or with destruction of the continuity of lymphatic channels. Basically, secondary lymphedema, which I presume this case to be, indicates first the