[Principles and results of physiotherapeutic therapy in mechanical lymphatic insufficiency of secondary or primary nature].

The modern treatment of edemas in mechanical lymphatic insufficiency or lymphedema, combines the restarting of the remaining lymphatic system by manual lymphatic drainage, volumetric reduction by wrapping with bandages and exercise and maintaining the result by wearing a retention device. Intensive courses are necessary, followed by intercurrent course & sometimes a maintenance treatment. In view of the anatomico-functional deficit, all available armamentarium should be used in addition to the measures previously mentioned: hygiene measures, prescription of coumarin (Lysedem). Psychological care is of importance to motivate patients for long-term treatments, if good quality results are to be obtained. However, primary lymphedema seems to respond less favorably than secondary lymphedema.