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Background: As we did not find any reliable datas concerning the prevalance of lipoedema (in Middle Europe), we started an anamnestic, clinical and (duplex-)sonographic investigation in 62 professional women. We were endavoured to avoid a bias of assertion and to get a socially correct composition of the collective. Results: Including all stages of lipoedema, also the mild ones (lipohyperplasia), 39 % of women were concerned. Regarding only the moderate to distict findings of markedly filled in ankles, 9.7 % were concerned. Only the breeches-type was found in 4.8 %. There were no relevant differences in age, length and age of menarche in women without and with lipoedema. Women with lipoedema were heavier than those without and they had accordingly a higher body-mass index. The thickness of subcutis + cutis 8 cm above the medial malleolus was 11 ± 2.8 mm in women without lipoedema and about 16 mm in those with lipoedema (beyond the double standard deviation). The thickness of the cutis lied on average distictly under 2 mm in both groups. Sonography seems to be a safe tool in the judgment of the subcutis – also in epidemiological studies.
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Under the direction of the German Society of Phlebology (Deutsche Gesellschaft für Phlebologie) and in cooperation with other specialist associations, the S1 guideline on intermittent pneumatic compression (IPC) was adopted in January 2018. It replaces the previous guideline from March 2005. The aim of the guideline is to optimize the indication and therapeutic use of IPC in vascular diseases and edema. An extensive literature search of MEDLINE, existing guidelines, and work relevant to the topic was performed. In view of the often methodologically weak study quality with often small numbers of cases and heterogeneous treatment protocols, recommendations can often only be derived from the available data using good clinical practice/expert consensus. Intermittent pneumatic compression is used for thromboembolism prophylaxis, decongestive therapy for edema, and to positively influence arterial and venous circulation to improve clinical symptoms and accelerate ulcer healing in both the outpatient and inpatient care setting. The therapy regimens and devices used depend on the indication and target location. They can be used as outpatient and inpatient devices as well as at home for long-term indications. A target indication is thrombosis prophylaxis. IPC should be used in severe chronic venous insufficiency (stages C4b to C6), in extremity lymphedema as an add-on therapy and in peripheral arterial occlusive disease (PAOD) with stable intermittent claudication or critical ischemia. IPC can be used in post-traumatic edema, therapy-resistant venous edema, lipedema and hemiplegia with sensory deficits and edema. Absolute and relative contraindications to IPC must be taken into account and risks considered and avoided as far as possible. Adverse events are extremely rare if IPC is used correctly. If the indication and application are correct-also as an add-on therapy-it is a safe and effective treatment method, especially for the treatment of the described vascular diseases and edema as well as thrombosis prophylaxis.
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