Surgical therapy of lymphoedema in Switzerland: Challenge for the surgeon with benefit for the patient?

Abstract

As long ago as 1892, Alexander von Winiwarter first published an article about the treatment of elephantiasis, applying the four cornerstones of conservative complex physical decongestion therapy (CDT) [1]. Today, this concept is still effective and includes gentle massage, local compression, physical exercises and meticulous skin care. In the 1930s, Emil Vodder realised that some specific massage techniques were able to reduce oedema volume. Unfortunately, he was not acknowledged adequately, despite publishing his results. Later on, Johannes Asdonk, a German general practitioner with experience in war surgery, realised the medical significance of these massage techniques, for both oedema treatment and optimised wound healing. Together with Emil Vodder, he launched several schools of massage and established the first clinic dedicated to lymphoedema (Asdonkklinik) in the Black Forest, offering specific treatment to patients affected by lymphoedema. Michael Földi, one of his staff members, was the first to demonstrate scientifically the mode of action and efficacy of CDT, and became one of the opinion leaders in lymphology [1].