CC BY-NC-ND 4.0 · Indian J Plast Surg 2009; 42(01): 022-030
DOI: 10.1055/s-0039-1699307
Original Article
Association of Plastic Surgeons of India

Comparative results of non-operative multi-modal therapy for filarial lymphoedema

S. B. Gogia
Sanwari Bai Surgical Centre, 28/31 Old Rajinder Nagar, New Delhi - 110 060, India
N. C. Appavoo
1  Director of Public Health, Directorate of Health Services, Tamil Nadu, India
A. Mohan
2  Filaria Therapy Control Unit, Chengalpattu Dist, Tamil Nadu, India
M. Burney Kumar
2  Filaria Therapy Control Unit, Chengalpattu Dist, Tamil Nadu, India
› Author Affiliations
Further Information

Publication History

Publication Date:
15 January 2020 (online)


A comparative analysis of different conservative modes of therapy for lymphoedema, largely of Filarial origin, was conducted in a trial therapy unit in Chengalpattu, a Filarial endemic district in Tamil Nadu. Results were compared using a single chambered intermittent pneumatic compression pump, heat therapy, and interferential therapy machines. The results showed improvement of limb size between 20% and 60% of possible reduction (where 100% would mean return of limb circumference to the same as that of the normal side). Pneumatic compression therapy, when used alone, showed the best results, which were significantly better than all others whether alone or in combination.


  • 1 Ahuja MM. Progress in clinical medicine. Vol. 1. Arnold Heinnemann; 1976. p. 25.
  • 2 Priya R. AIDS, public health and the panic reaction (Part I). Nat Med J India 1994;7:235-40.
  • 3 Foldi M. Cited in Progress in Lymphology. In: Mayall, White, editors. Plenum Press; 1977. p. 293.
  • 4 Rusznayak I, Foldi M, Szabo G. Lymphatics and lymph circulation. 2nd ed. Pergamon Press; 1967.
  • 5 Clinical Features, Pathogenesis and Management of Lymphatic filariasis. In: Pani SP, Lall R, editors. Vol. 28. I.C.M.R. Bullettin; 1998. p. 41-9.
  • 6 Srividya A, Pani SP, Rajagopalan PK, Bundy DA, Grenfell BT. The dynamics of infection and disease in Bancroftian filariasis. Trans R Soc Trop Med Hyg 1991;85:255-9.
  • 7 Sabesan S, Krishnamoorthy K, Panicker KN, Vanamail P. The dynamics of Microfilaremia and its relation with the development of disease in periodic Brugia malayi infection in South India. Epidemiol Infect 1991;107:453-63.
  • 8 Drinker CK, Yoffrey JM. Lymphatics lymph and lymphoid tissue. Cambridge, Massachusets: Harvard Univ. Press; 1941.
  • 9 Casley-Smith JR, Clodius L, Piller NB. Tissue changes in chronic experimental lymphoedema in dogs. Lymphology 1980;13:130.
  • 10 Zimmerman and Takats. The mechanism of thrombophlebitic edema. Arch Surg 1931;23:937.
  • 11 Pani SP, Krishnamoorthy K, Rao AS, Prathiba J. Parasite prevalence and clinical manifestations in malayan filariasis with special reference to lymphoedema grading. Ind J Med Res 1990;91:200-7.
  • 12 Dandapat MC, Mohapatro SK, Dash DM. Management of the chronic manifestations of filariasis. J Indian Med Assoc 1986;84:210-5.
  • 13 Bosworth W, Ewert A. Effect of streptococci on the persistence of Brugia malayi and on the production of elephantiasis in cats. Int J Parasitol 1975;5:583-9.
  • 14 Cao WC, Xu JF, Ren ZX. Epidemiological surveillance of filariasis after its control in Shandong Province, China. Southeast Asian J Trop Med Public Health 1994;25:714-8.
  • 15 Doldi SB, Lattuada E, Zappa MA, Pieri G, Favara A, Micheletto G. Ultrasonography of extremity lymphoedema. Lymphology 1992;25:129-33.
  • 16 Brush B E, Heidt I. Device for the relief of lymphoedema. JAMA 1956;158:34.
  • 17 Nelson PA. Recent advances in treatment of lymphoedema of the extremities. Geriatrics 1966;21:162.
  • 18 Wakim KG, Martin GM, Krusen FH. Influence of centripetal rhythmic compression on localised edema of an extremity. Arch Phys Med 1955;36:98-103.
  • 19 Zelikovski A, Haddad M, Reiss R. Non- operative surgery combined with limited surgery in management of peripheral lymphoedema. Lymphology 1986;19:106-8.
  • 20 Raines JK, O'Donnell TF Jr, Kalisher L, Darling RC. Selection of patients with lymphoedema for compression therapy. Am J Surg 1977;133:430-7.
  • 21 Olszewski WL. What is lymphology in 1991. Lymphology 1992;25:50-4.
  • 22 Clodius L, Földi E, Földi M. On non operative management of chronic lymphoedema. Lymphology 1990;23:2-3.
  • 23 Bunce IH, Mirolo BR, Hennessy JM, Ward LC, Jones LC. Post mastectomy lymphoedema treatment and measurement. Med J Aust 1994;161:125-8.
  • 24 Wozneiski M. Value of intermittent pneumatic compression in the treatment of upper extremity oedema. Pol Tyg Lek 1991;46:552.
  • 25 Casley Smith JR. Personal communication; - during the 2nd conference of the Lymphology Society of India, Chennai: 1997.
  • 26 Miller GE, Seale J. Lymphatic clearance during compressive loading. Lymphology 1981;14: 161-6.
  • 27 Madan NC, Dhawan IK, Gogia SB, Narayan J. A simplified treatment for lymphoedema. Proc. VII Int Conf. Plast Surg Ontario, Canada: 1983. p. 1644.
  • 28 Rose K, Taylor H, Twycross R. Volume reduction of arm lymphoedema. Nurs Stand 1993;7:29.
  • 29 Bihari I, Meleg M. Conservative management of lymphoedema of the limbs. Orv Hetil 1991;132:1705-8.
  • 30 Tambwekar S. Mumbai, Personal communication- during the first Conference of the Lymphology society of India - Thanjavur, Tamil Nadu: 1996.
  • 31 Chang TS, Han LY, Gan JL, Huang WY. Microwave; an alternative to electric heating in the treatment of peripheral lymphoedema. Lymphology 1989;22:20-4.
  • 32 Anitha K, Shenoy RK. Treatment of lymphatic filariasis: Current trends. Indian J Dermatol Venereol Leprol 2001;67:60-5.
  • 33 Fritsch C, Tomson D. The usefulness of lymphatic drainage. Sweisch Rundsch Med Prax 1991;80:383-6.