Treatment of elephantiasis of the legs

Treatment of elephantiasis of the legs is carried out by a doctor, focusing on the results of the diagnostics. Several approaches are used for treatment, let's consider them:

1. Drug therapy

Depending on the stage of elephantiasis, special medications are selected for the patient. Medicines reduce lymph formation, improve tissue nutrition and the condition of the lymphatic vessels. Medicines help remove metabolic products from the body and prevent the growth of fibrous tissue.

2. Surgical treatment

It is aimed at reducing the volume of the affected limb by creating new pathways for the outflow of lymphatic fluid. The operation is performed in case of progressive lymph stagnation and hard edema with pronounced pain. Surgery is necessary in case of formation of lymphatic sacs, recurrent erysipelas and proliferation of connective tissue in the limb.

In case of primary lymphedema, transplantation of tissue lymphoid complex is possible. In case of severe stage of elephantiasis, the possibility of performing operations is excluded, therefore tunneling is indicated. The surgeon creates passages for draining lymph into healthy tissues.

3. Non-drug treatment

The patient is prescribed physiotherapy procedures and therapeutic exercises, lymphatic drainage massage, balneotherapy and wearing compression hosiery. Particular attention is paid to nutrition and lifestyle.

Regardless of the chosen method, treatment of elephantiasis of the legs is a long process that requires comprehensive medical supervision. Based on this, no alternative treatment methods (homeopathy, traditional medicine, herbal medicine) will help restore the physiological functioning of the damaged limb.

How to treat elephantiasis of the legs at home?

Treatment of elephantiasis of the lower extremities at home is carried out according to the treatment plan drawn up by the doctor. The main goal that both the doctor and the patient set for themselves is the removal of excess lymph from the extremities or other organs, the restoration of its normal outflow.

For this purpose, the patient is prescribed the following procedures:

• Manual lymphatic drainage massage course.
• Wearing compression garments.
• Physiotherapy (hardware pneumatic compression, hydromassage, laser therapy).
• Diet food.

Particular attention is paid to the diet, since its results depend entirely on the patient's efforts. In lymphostasis, first of all, it is necessary to limit or completely eliminate the use of salt. This food product retains fluid in the body, including lymphatic fluid.

The main diet should be products of plant and animal origin, providing the body with a complex of useful micro and macroelements. Protein foods and fats have a membrane-stabilizing effect, which increases lymph flow, so they should also be present in the diet.

Following all medical prescriptions in combination with a balanced diet and therapeutic exercises allows achieving a positive effect in the treatment of elephantiasis of the legs.

Medicines

Depending on the stage and form of elephantiasis, the doctor draws up a drug therapy regimen. Medicines are necessary to normalize lymph circulation and improve the condition of the lymphatic vessels, prevent the growth of fibrous tissue and improve nutrition.

The use of drugs is carried out in combination with conservative methods. This contributes to a rapid improvement in the patient's condition and accelerates the recovery period. Drug therapy includes several groups of drugs:

Phlebotonics - their action is aimed at strengthening the walls of blood vessels. The drugs are available in the form of tablets, injection solutions, ointments, gel.

• Detralex

A drug from the group of venotonics. Increases the tone of veins, makes them elastic and stretchable. Improves hemodynamics and reduces stasis. Stops the adhesion of leukocytes to the walls of the endothelium, reduces the damaging effect of inflammation mediators.

• Indications for use: venous insufficiency of the lower extremities, ulcer complications, treatment of acute and chronic hemorrhoids.
• Directions for use: one capsule twice daily during meals. Duration of treatment depends on the severity of the disease and is about 90 days.
• Side effects: dyspeptic and neurovegetative disorders. No cases of overdose have been identified.
• Contraindications: intolerance to the components of the drug, last trimester of pregnancy.

The drug is available in tablet form and in packaging of 30/60 capsules.

• Troxevasin

Reduces the severity of edema in chronic venous insufficiency. Minimizes pain, eliminates cramps, trophic and varicose ulcers. Affects the rheological properties of blood, prevents the appearance of vascular microthrombi.

• Indications for use: trophic disorders in varicose veins and trophic ulcers, venous insufficiency. Auxiliary agent in atherosclerosis and arterial hypertension.
• The method of application depends on the form of the drug. The capsules are taken orally during meals in a dosage of 2 pcs. per day. The gel is applied with massaging movements to the affected areas of the skin 2 times a day. The course of treatment is a month.
• Side effects: skin allergic reactions, dermatitis, eczema.
• Contraindications: hypersensitivity to the components of the drug, first trimester of pregnancy, gastric ulcer and duodenal ulcer, gastritis. With special caution it is prescribed in case of renal failure.

Troxevasin is available in capsule form, with 300 mg of active ingredients in each.

• Aescusan

A medicinal product with herbal composition. It has anti-edematous, anti-exudative, venotonic, antioxidant and capillary-protective properties. The anti-edematous effect of the drug is associated with the ability of the active component to reduce the permeability of the plasma-lymphatic barrier and reduce lymph flow.

• Indications for use: chronic venous insufficiency of various etiologies, edema and cramps of the lower extremities. Pain, heaviness and itching of the legs. Dilated veins, spider veins and hematomas. Post-thrombophlebitic syndrome, trophic changes, inflammation of soft tissues.
• Directions for use: Take 10-15 drops of oral solution 3 times a day before meals. Take 1 tablet 3 times a day. The course of treatment is about 90 days.
• Side effects: irritation of the gastrointestinal mucosa, dyspeptic phenomena, nausea, vomiting, allergic reactions. In case of overdose, side effects are aggravated, treatment is symptomatic.
• Contraindications: hypersensitivity to the components of the drug, early pregnancy and lactation, renal failure, childhood.

Aescusan is available in the form of drops for oral use and tablets.

Enzymes are enzyme substances that prevent the formation of blood clots and thrombi. They have anti-inflammatory and immunostimulating effects. They eliminate swelling and enhance the effect of angioprotectors and phlebotonics.

• Wobenzym

A combination of highly active enzymes of animal and plant origin. Has anti-inflammatory, anti-edematous, immunomodulatory, fibrinolytic properties.

• Indications for use: lymphedema, secondary lymphatic edema, post-thrombotic syndrome, vasculitis, thrombophlebitis. The drug is also used in rheumatology, urology, gynecology, traumatology, pulmonology, cardiology, gastroenterology, dermatology, nephrology and neurology.
• Directions for use: 5-10 pills 3 times a day. Maintenance dose is 3-5 pills per day. Duration of treatment is determined by the attending physician.
• Side effects: allergic skin rashes, bowel disorders.
• Contraindications: intolerance to the components of the drug. High risk of bleeding, hemophilia, thrombocytopenia. Use during pregnancy is possible only with a doctor's permission.

It is produced in the form of enteric-coated dragees in packages of 40, 200 and 800 pieces.

• Lymphomyosot

A drug from the homotoxic series. It has anti-edematous, anti-inflammatory, lymphatic drainage, and detoxifying properties. Stimulates metabolism, increases the barrier functions of lymph nodes, improves tissue drainage, and enhances the elimination of pathogenic microorganisms.

• Indications for use: elephantiasis, lymphatic edema, drug and other intoxications, immunodeficiency states, diabetes mellitus with polyneuropathy, perineural edema, exudative-catarrhal diathesis. Dysbiosis, renal and cardiac edema, skin diseases, asthenia, malignant and benign lesions.
• Method of administration: the drug is taken orally and used for parenteral administration. The dosage and duration of therapy is determined by the attending physician, individually for each patient.
• Contraindications: thyrotoxicosis, hyperthyroidism, pregnancy and lactation. No cases of overdose have been recorded.

The medicine is available in the form of drops for internal and sublingual use, as well as in ampoules for parenteral use.

• Phlogenzym

Combined medicinal product. Contains a complex of hydrolytic enzymes for oral use. The drug has anti-edematous, anti-inflammatory, antioxidant, antiplatelet and analgesic properties.

• Indications for use: acute inflammatory processes in the body, chronic inflammatory-degenerative diseases, traumatic lesions with tissue inflammation. Inflammatory diseases of the veins, lymphatic vessels, arteries. Rheumatological diseases.
• Method of application: tablets are used orally, 3 pcs. twice a day. Duration of treatment is from two weeks until complete recovery.
• Side effects: gastrointestinal disorders, allergic reactions, increased sweating.
• Contraindications: hypersensitivity to the components of the drug, lactose intolerance, blood clotting disorders, severe liver dysfunction. Not used in pediatric practice and before surgical interventions. Use during pregnancy is possible only on medical prescription.

The drug is available in the form of enteric-coated capsules. The drug is packaged in 20, 40, 100 and 200 tablets.

Angioprotectors – protect vascular walls by increasing the endothelium’s resistance to harmful microorganisms. Increase the elasticity of blood vessels and protect them from fragility. Enrich tissues with oxygen and improve their nutrition.

• Actovegin

Activates cellular metabolism and increases cellular energy resources.

• Indications for use: trophic disorders in varicose veins of the lower extremities, ulcers of various etiologies, bedsores, burns, radiation injuries. Insufficiency of cerebral circulation, ischemic stroke, craniocerebral injuries, disorders of peripheral circulation. Corneal damage.
• The method of administration and dosage depend on the severity of the disease. The medicine is taken orally, parenterally and applied locally to the affected areas. The duration of treatment is determined by the doctor.
• Side effects: allergic reactions, increased sweating, increased body temperature, feeling of blood rush.
• Contraindications: hypersensitivity to the drug, pregnancy and lactation.

Actovegin is available in the form of dragees, injection solution in ampoules, infusion solution, as well as in the form of gel, cream and ointment.

• Trental

A medicinal product for improving microcirculation. Contains the active component – pentoxifylline. Improves blood rheological properties, normalizes red blood cell elasticity, reduces platelet aggregation and blood viscosity. Reduces plasma fibrinogen concentrations and improves fibrinolysis. Improves microcirculation and cellular respiration.

• Indications for use: encephalopathy of atherosclerotic genesis, ischemic stroke, peripheral circulatory disorders, angioneuropathy, Raynaud's disease, paresthesia, trophic ulcers, circulatory failure.
• Method of administration: injection solution is administered intravenously by jet or drip. Tablets are taken orally 2-4 pcs. 2-3 times a day.
• Side effects: gastrointestinal disorders, hyperemia of the face and upper body, angina, heart rhythm disturbances. Headaches, sleep and wakefulness disturbances, skin allergic reactions.
• Contraindications: hypersensitivity to the components of the drug, hemorrhagic stroke, tendency to bleeding, pregnancy and lactation, retinal hemorrhages.
• Overdose: nausea, vomiting, headaches, tachycardia, elevated body temperature, loss of consciousness, convulsions. There is no specific antidote. Gastric lavage and enterosorbents are indicated for treatment.

Trental is available as an injection solution and as enteric-coated tablets.

• Venitan

Angioprotector for external use. Its active component is dry extract of horse chestnut. It has anti-edematous, anti-inflammatory and venotonic properties.

• Indications for use: lymphatic edema of various localizations, varicose veins, venous insufficiency, severe pain in the legs, hematomas after injuries and injections.
• Directions for use: Apply a thin layer of the preparation to intact skin 1-3 times a day. The course of treatment is individual for each patient.
• Side effects: skin allergic reactions, itching, rash, urticaria. No cases of overdose have been reported.
• Contraindications: intolerance to the components of the drug, application to damaged tissues and mucous membranes. Not used to treat patients under 16 years of age, during pregnancy and lactation.

Venitan is available in the form of cream and gel for external use, 50 g per tube.

Antibiotics and anti-inflammatory drugs are prescribed for infectious lymphostasis and the development of secondary infection. They are used for erysipelas, that is, severe damage to the subcutaneous tissue.

• Amoxiclav

Antibacterial combination agent with the active substance amoxicillin. Has activity against a wide range of pathogenic microorganisms.

• Indications for use: infectious elephantiasis, sinusitis (acute, chronic), pneumonia, bronchitis, urinary tract infections, retropharyngeal abscess, skin and soft tissue infections, gynecological infections, infectious lesions of bones and joints. Prevention of purulent-septic complications.
• The method of administration and dosage depend on the form of the medication and the severity of the painful condition.
• Side effects: gastrointestinal disorders, allergic skin rashes, nervous system disorders. Thrombocytopenia, hepatobiliary disorders, hematuria, candidiasis.
• Contraindications: cholestatic jaundice, hepatitis, hypersensitivity to the components of the drug, pregnancy and lactation.
• Overdose: sleep disturbances, increased agitation, headaches and dizziness, convulsions. Treatment is symptomatic, hemodialysis may be performed.

The antibiotic is available in the form of tablets, powder for the preparation of oral suspension, powder for the preparation of solution for parenteral administration.

• Oletetrin

A combined antimicrobial agent with tetracycline and oleandomycin. It has pronounced bacterial activity and a broad spectrum of action.

• Indications for use: infectious and inflammatory diseases of various etiologies and localizations. Effective in pathologies of the genitourinary system, digestive tract. Used for meningitis, brucellosis, soft tissue infections of an infectious nature.
• Method of application: the drug is taken 2-3 capsules per day. The course of treatment is determined by the attending physician, individually for each patient.
• Side effects: gastrointestinal disorders (loss of appetite, epigastric pain, nausea and vomiting, dysphagia), increased fatigue, headaches and dizziness, changes in the blood system and allergic reactions.
• Contraindications: intolerance to tetracycline antibiotics, severe renal and hepatic dysfunction, leukopenia. Not prescribed for patients under 12 years of age, as well as during pregnancy and lactation.
• Overdose: gastrointestinal disorders, allergic reactions, headaches. Specific antidote unknown.

Oletetrin is available in the form of tablets for oral use, 10 pieces per blister, two blisters per package.

• Azithromycin

A broad-spectrum antibiotic. Creates high concentrations in the affected areas, providing a bactericidal effect.

• Indications for use: infectious diseases caused by microorganisms sensitive to the drug. Skin and soft tissue infections (erysipelas), lesions of the upper and lower respiratory tract and ENT organs, genitourinary infections, Lyme disease.
• Directions for use: 500 mg 3 times a day for 3 days.
• Side effects: nausea and vomiting, bowel disturbances, transient increase in liver enzyme activity, skin rashes.
• Contraindications: hypersensitivity to macrolides, severe renal and hepatic dysfunction. Not prescribed during pregnancy and lactation. Use with special caution in patients with a history of allergic reactions.

The medicine is available in the form of capsules, tablets and powder for oral use.

Antihistamines – used for lymphostasis caused by erysipelas. Minimize the effect of histamine on the contractility of lymphatic vessels.

• Suprastin

An antihistamine that blocks H1-histamine receptors.

• Indications for use: dermatoses, rhinitis, Quincke's edema, conjunctivitis, bronchial asthma.

• Method of administration: tablets are taken 250 mg 2-3 times a day. In particularly severe cases, intramuscular or intravenous administration of 1-2 ml of a 2% solution of the drug is possible.
• Side effects: increased weakness and drowsiness.
• Contraindications: glaucoma and prostatic hypertrophy. Not prescribed for patients whose work involves driving a vehicle or requires quick reactions.

Suprastin is available in tablet form and is also available in ampoules of 1 ml of 2% solution.

• Claritin

Antihistamine, selective H1-receptor blocker. Contains the active ingredient loratadine. The therapeutic effect develops within 1-2 hours and reaches its maximum effect within 8-12 hours. The antihistamine effect lasts for 24 hours.

• Indications for use: allergic skin diseases, rhinitis, renorrhea, itching and burning in the eyes.
• Directions for use: 1 tablet once a day.
• Side effects: nausea, vomiting, dry mouth, hepatitis. In rare cases, anaphylactic reactions and CNS disorders (increased fatigue, headaches, drowsiness), skin rashes occur.
• Contraindications: intolerance to the components of the drug, pregnancy and lactation, childhood of patients.
• Overdose: increased heart rate, headaches, increased drowsiness. Treatment includes gastric lavage, intake of adsorbents and further symptomatic therapy.

Claritin is available in tablet form and also as a syrup for oral use.

• Erius

Antihistamine, selective blocker of peripheral H1-histamine receptors. Does not have a sedative effect, relieves inflammatory and allergic reactions of various etiologies.

• Indications for use: idiopathic chronic urticaria, persistent and intermittent rhinitis, hay fever, dermatitis, eczema.
• Directions for use: 1 tablet once daily, 10 ml syrup once daily. Dosage for pediatric patients is adjusted by the attending physician.
• Side effects: headaches and dizziness, hypersensitivity reactions, increased fatigue, increased heart rate, increased activity of liver enzymes.
• Contraindications: hypersensitivity to the components of the drug, pregnancy and lactation.
• Overdose is manifested by increased side effects. Treatment is symptomatic.

The drug is available in tablet form and also as a syrup for oral use.

• Diuretics - diuretic drugs are necessary to remove excess fluid from the body. But they can only be taken on doctor's prescription and in emergency cases. This is due to the fact that the drugs promote the movement of fluid into the vascular bed, causing additional complications. Some drugs are dangerous because they wash out potassium and other minerals from the body.
• Immunomodulators – increase the protective properties of the immune system and have a positive effect on the condition of vascular walls.

The effectiveness of drug treatment for elephantiasis of the legs depends on the correctness of the treatment plan. During the therapy, the patient periodically takes a number of tests to monitor the condition of the body.

Vitamins

To improve tissue trophism and nutrition in elephantiasis, as well as to prevent the proliferation of connective fibers, patients are prescribed vitamins.

• A – removes excess fluid from the body and helps get rid of swelling. Retinol is found in fatty fish, milk, eggs, and liver.
• B1 – thiamine is necessary for the correction of circulatory disorders. Deficiency of this substance is manifested by severe swelling of the extremities, increased weakness, rapid muscle fatigue and paresthesia of the legs. The vitamin is found in meat, offal, grain crops and soy.
• B9 – regulates the processes of hematopoiesis in the body, stimulates the formation of red blood cells. Affects the level of hemoglobin and the degree of saturation of red blood cells with oxygen. Normalizes the level of cholesterol and fats in the blood. Folic acid prevents the development of atherosclerosis, removes fat breakdown products. The vitamin is found in vegetables, tomatoes, legumes, and grains.
• C – has pronounced diuretic properties. Citrus fruits, black currants, kiwi, sweet potatoes, strawberries, broccoli are rich in ascorbic acid.
• E is a powerful antioxidant with anti-sclerotic properties. Maintains normal blood pressure. Restores blood circulation, stabilizes capillary wall membranes, regulates blood sugar levels and the functioning of the coagulation system. Tocopherol improves tissue respiration and prevents the frequency of convulsive contractions of the calf muscles. The vitamin is found in sprouted wheat and rye grains, legumes, soybeans, and green onions.
• K – phylloquinone regulates the normal functioning of the circulatory system and improves the condition of blood vessels. Deficiency of this substance leads to insufficient formation of fibrin, which is manifested by frequent bleeding. It takes part in the mechanism of blood clotting, evenly distributing it through the vessels. It is contained in cabbage and lettuce leaves, tomatoes, potatoes, rowan berries, green tea, beef liver.
• R – takes part in key metabolic processes in the body. It is used to prevent edema. It has an analgesic effect, stops inflammatory reactions in the body. Provides sufficient elasticity and strength of vascular walls. It is necessary for the complete absorption and metabolism of vitamin C. Horse chestnut, citrus fruits, tea, coffee, rowan, lingonberry, cranberry, hazelnuts are rich in rutin.

The lymphatic system is closely connected with the immune system, so it needs additional stimulation. Vitamins and natural immunostimulants are great for this. Useful substances can be obtained from pharmaceutical preparations and from a complete diet.

Physiotherapy treatment

An essential component of the treatment of lower limb lymphedema is physiotherapy. This method has the following properties:

• Restores lymph circulation.
• Reduces signs of inflammation.
• Reduces the incidence of fibrous growths.

Patients are prescribed the following physiotherapy procedures:

1. Electrophoresis is the effect of galvanic current on tissues and the introduction of drugs. The procedure uses enzymatic agents that improve fluid circulation in tissues.
2. Magnetotherapy – with the help of bioelectric signals, the circulation of lymph and venous blood is improved, which leads to the contraction of small vessels. It has an anti-inflammatory effect.
3. Hardware pneumatic compression – special devices are used for treatment, which stimulate lymph flow using massage and squeezing movements. The massage is performed using wave-like movements that improve tissue nutrition.
4. Phonophoresis – enzyme preparations are introduced into the tissue to improve microcirculation and restore vascular patency. The drugs are administered using ultrasound waves. The therapy is aimed at dissolving fibrin fibers and slowing down the hardening of edema.
5. Laser therapy is a physiotherapy procedure that involves the application of low-energy laser radiation to intact skin. It activates metabolic processes in the body, improves vascular microcirculation and reduces swelling.
6. Lymphatic drainage massage – both manual and machine massage can be used for treatment. Improves lymph flow due to the effect on lymphatic capillaries, nodes and vessels. The massage begins with the toes, moving smoothly along the lymphatic vessels. After the first procedure, swelling decreases and the condition of the vascular walls improves.

Another mandatory physiotherapeutic method is therapeutic exercise. With the help of special exercises, the movement of lymph is improved. Physical exercise should be performed in compression hosiery. The mechanism of its therapeutic action is aimed at improving the functioning of the muscular system and evacuating fluid from the tissues back into the vessels. Exercises are performed slowly, 5-10 times each, gradually increasing the number of repetitions.

In addition to the above physiotherapeutic procedures, wearing compression hosiery is indicated for the treatment of elephantiasis. This method protects the limbs and increases tissue respiration, removes excess fluid from the intercellular space, and reduces swelling. Prevents the formation of fibrin fibers. In the first few weeks, tight bandaging with poorly elastic bandages is indicated. At the next stage, compression hosiery (knee-highs, stockings) is selected for constant wear.

Folk remedies

An alternative method of treating elephantiasis is folk therapy. The following remedies are recommended to improve the functioning of the lymphatic system:

• Succinic acid – improves oxygen absorption at the cellular level, restores energy metabolism. Increases the body's resistance to aggressive environmental factors. It is used as an auxiliary agent in the treatment of lymphostasis, accelerates recovery.
• Eleutherococcus - has immunostimulating and tonic properties. For treatment, use the extract of the plant's roots, taking 30-50 drops 1-2 times a day.
• Beekeeping products - honey and royal jelly are suitable for both internal and external use. They improve tissue respiration and relieve swelling.

Folk remedies for lymphedema:

• Take 250 g of peeled garlic and chop it thoroughly. Transfer the raw material into a glass jar and pour 350 g of honey. Mix the ingredients and let it brew in a dark place for 5-7 days. Take a tablespoon 3 times a day 30 minutes before meals. The course of treatment is 1-2 months. Garlic contains active components that cleanse the lymph, stimulate the muscular walls of blood vessels, improve blood circulation and strengthen the immune system.
• Mix a teaspoon of chicory with the same amount of crushed ginger root. Pour a glass of boiling water over the raw material and let it brew. Take the drink for 10 days. The product has a vasodilatory effect, removes toxins, accelerates the movement of blood and lymph in the body.
• Take a couple of tablespoons of crushed hazelnut leaves. Pour the raw material into a thermos and pour 500 ml of boiling water. The drink should be infused for 2-3 hours. After straining, take ½ cup 30 minutes before meals 3-4 times a day. The infusion improves blood circulation in the lower extremities, accelerates the healing of trophic ulcers.

Before using folk remedies, you should consult with your doctor and make sure that there are no allergic reactions to the components of the recipes used.

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Herbal treatment

Another unconventional method of treating leg lymphostasis is the use of medicinal components of plant origin.

Effective recipes:

• Pour a glass of boiling water over a tablespoon of dry plantain leaves and let it brew for 12 hours. Take the infusion ½ glass 2 times a day. In the early stages of treatment, plantain stops the development of edema, helps in the treatment of lymphostasis caused by pathogenic flora and infections.
• Wash dandelion roots well, cut into small pieces and dry. Pour 500 ml of boiling water over a tablespoon of raw material and bring to a boil over low heat. Take ½ cup in the morning before breakfast. Dandelion reduces swelling and minimizes pain in the lower extremities. Tones the walls of blood vessels, prevents the formation of blood clots.
• Pour 500 ml of boiling water over two teaspoons of Ivan tea, add a teaspoon of honey and ginger. Let the drink brew for 15-20 minutes. Take the remedy 2-3 times a day. Ivan tea restores lymph flow, relieves swelling and reduces pain.
• Take equal proportions of St. John's wort, succession, chamomile, yarrow, tansy flowers and nettle. Mix all the ingredients and pour boiling water in a ratio of 1:7 and simmer for 30 minutes. The remedy should be infused for 3-5 hours. Take ½ cup daily until the symptoms of elephantiasis disappear. This recipe is most effective for infectious diseases.
• Take 1 large onion and bake it in the oven. Once it cools, grind it to a mushy state, adding a couple of cloves of garlic and a spoonful of honey. The herbal mixture should be applied to the affected tissues and wrapped with an elastic bandage. The remedy is effective for post-traumatic lymphostasis of the legs.

When using herbal medicine, it should be taken into account that infusions, decoctions and compresses cannot replace the complex therapy prescribed by a doctor.

Homeopathy

There are homeopathic remedies for the treatment of lymphedema of the lower extremities:

• Apis Baryta muriatica, Fluoricum acidum, Apis mellifica – persistent lymphatic congestion, hard edema.
• Baryta muriatica – the lymph nodes are enlarged and painful, prone to purulent processes.
• Fluoricum acidum – tendency to persistent swelling of the legs of any etiology.
  Graphithes – effective in early stages of lymphostasis.
• Hydrocotyle asiatica – swelling of the lower extremities with skin lesions and annular scleroderma.
• Myristica – elephantiasis after erysipelas.
• Ledum – elephantiasis of both limbs.
• Lycopodium – impaired lymph flow on the right.

The dosage and method of administration of homeopathic medicines are selected by the doctor, individually for each patient.

Surgical treatment of elephantiasis of the legs

If conservative treatment in combination with physiotherapy has proven ineffective and lymphedema progresses, then surgery is indicated. Surgical treatment of elephantiasis is aimed at creating new pathways for the outflow of lymphatic fluid and reducing the volume of affected tissue.

Indications for surgery:

• Progressive lymphatic congestion.
• Overgrowth of connective tissue in the limb.
• Recurrent erysipelas.
• Formation of lymphatic sacs.
• Severe pain syndrome.

Before surgery, the patient must undergo preparation:

• Get an electrocardiogram and chest x-ray, and take a series of laboratory tests.
• If the test results reveal an inflammatory process, then a course of antibiotics is prescribed and the operation is postponed for 1-1.5 months.
• To plan the operation and clarify the patient's condition, magnetic resonance imaging of the affected tissues is performed.
• Before the operation, a special diet is prescribed, enriched with proteins and vitamins. It is recommended to limit the consumption of salt and liquids.

The main methods of surgical treatment of elephantiasis of the legs:

1. Lymphangiectomy – is performed in cases of severe fibrous tissue changes, limb deformation and frequent infectious processes. The surgeon performs complete or partial removal of lymphatic vessels with subcutaneous fat and fascia. The operation consists of several stages.
2. Lymphatic drainage shunting – this method is effective in the early stages of the disease with local hypoplasia of the lymphatic vessels. In secondary lymphedema, surgery is not always possible, since anastomoses should be applied only to isolated tissues.
3. Tunneling – is performed in cases of severe elephantiasis of the legs, when other operations are contraindicated. The treatment is based on creating passages to drain fluid into healthy tissues.
4. Liposuction is the removal of fatty tissue with fibrous growths. The operation is most effective in the early stages of the disease, when the volume of connective tissue in the cellulose is minimal.

Surgery is contraindicated in cases of blood and cardiovascular diseases, for elderly patients, and in cases of kidney, liver and lung pathologies.

Special attention is paid to rehabilitation after the operation. After the doctor has stitched up the wound, the operated limb is tightly bandaged and any loads on it are limited. To prevent purulent complications, the patient is prescribed a course of antibiotics. A week later, a measured load on the limb is allowed. After two weeks, the stitches are removed. Physiotherapy is indicated to speed up healing and reduce the formation of cicatricial changes.