[Medical and surgical therapies. Their respective indications in lymphedema]

The treatment of lymphedema, medical or surgical, remains a difficult one. Often seen at an advanced stage of the disease, the medical treatment can only stabilize the lesions. Among them, the coumarins, rutins, Centella asiatica extracts, procyanoside oligomers are the most prescribed. But prophylaxis of superimposed infections by antibiotics should not be omitted. As for diuretics, they must be prohibited. Hygienic and dietetic measures should be recommended. As for surgical treatments, they are numerous and rarely applied, whether it consists of the tacking technique or Degni's lymphovenous anastomosis. The latter may be considered in case of high lymphatic obstruction, especially at the inguinal level. Servelle's lymphangiectomy, very traumatic, is only exceptionally indicated.