Common denominators for the low-cost management of leg conditions.
Diseases of blood supply and drainage of the leg are common, and they frequently contribute to poverty. Management must include self-help low-cost therapy. The phlebologist, lymphologist, angiologist, or dermatologist must seek to distill their knowledge for the health worker in the general health services. Such knowledge should focus on the venous system, which is amenable to simple maneuvers such as breathing, elevation, and movement. However, the mechanisms underlying the functions of the blood vessels and lymphatics and the organ they supply or drain are inextricably interwoven. Care of the veins, the lymphatics, and the epidermis depends on attention to each together and at the same time. New knowledge of cytokines produced by the epidermis and their effects on angiogenesis and permeability suggest that care of the epidermis by washing and emollients has equal value as elevation and movement. Such maneuvers cost little and are usually available.
Ryan
Terence J
TJ
Oxford Centre for Health Care Research and Development, Oxford, UK. tryan@brookes.ac.uk