the burden on the solidarity system in order to be able to continue to treat the individual in a secure way. The possi- bility of sparing money for health care insurances varies between 55 and 85% after 10 years, see Table III. Still we have to consider, that the relief is not only financial for the health care system, but a general saving of resources: The “resource” therapist, who is often not available during the acute decongestion phase, because the continuous ther- apy with MLD with 1–2 sessions of 45–60 minutes per week ties up mostly all capacities. Also, time-economically it is an advantage for the patient: he or she is not bound to appoint- ments and can combine the decongestion with other things, such as a nap, a telephone call or reading a book. In other countries, where the patient has to pay for IPC, MLD and possibly even compression and the doctor’s visit for lymphoedema completely themselves, the question is almost even more interesting and important for the individ- ual as a victim of the disease within the limits of their finan- cial possibilities. Summary The results of the present study suggest that compression stockings supplemented by IPC alone or in combination with MLD in the maintenance phase shows equivalent results to MLD alone – at least in a period of 4 weeks. The savings for the solidarity system in combining 1 MLD per month with IPC at home would be enormous – this would ensure continuity in contact with an experienced therapist who can recommend an appointment with the doctor if needed. This would then no longer take place quarterly but possibly annually. Further studies with the aim of making sensible use of resources and possibly implementing IPC in the deconges- tion phase, as well as accompanying the introduction of the IPC/MLD combinations, would be desirable. Electronic supplementary material The electronic supplementary material (ESM) is available with the online version of the article at https://doi.org/ 10.1024/0301-1526/a001090 ESM 1. General characteristics of the included subjects (Table) ESM 2. Final assessment of the different therapy options (Table) References 1. Wilting J, Bartkowski R, Baumeister R, Földi E, Stöhr S, Strubel G, et al. S2k Leitlinie: Diagnostik und Therapie der Lymphödeme (AWMF Reg.-Nr. 058-001). 2017. Verfügbar unter: https://register. awmf.org/assets/guidelines/058-001l_S2k_Diagnostik_und_ Therapie_der_Lymphoedeme_2019-07-abgelaufen.pdf 2. Földi M, Strößenreuther R. Grundlagen der manuellen Lym- phdrainage. 2. Aufl. München: Urban und Fischer; 2000. 3. 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Effect of manual lymph drainage in addition to guidelines and exercise therapy on arm lymphedema related to breast cancer: randomised controlled trial. BMJ. 2011;343:d5326. 8. Allofs J, Johnsen L, Devoogdt N, Stutterheim E, Hoppstädter W, Grüneberg C. Interkulturelle Adaptation des Lymph-ICF- Fragebogens für Patienten mit Lymphödemen der unteren Gliedmaßen in Deutschland. Physioscience. 2019;15:5–16. 9. Mendoza E, Amsler F. Efficacy of intermittent pneumatic compression in the treatment of oedema comparing calf compression with calf and thigh compression devices. Phle- bologie. 2019;48:112–22. 10. Cohen J. Things I have learned (so far). Am Psychol. 1990;45: 1304–12. History Submitted: 02.04.2023 Accepted after revision: 19.08.2023 Published online: 16.10.2023 Conflict of Interest EM declares that there are no conflicts of interest existing. FA was reimbursed for his statistical analysis at Bösl Medizintechnik GmbH and Bauerfeind AG. Open Data At the XIX World Congress of the International Society of Phlebology (UIP), 12th–16th September 2022 in Istanbul, Turkey. At the 64th meeting of the German Society of Phlebology September 29th–October 1st, Hanover, Germany. At the 49th Veith Symposium, November 15th–19th, New York, USA. ORCID Erika Mendoza https://orcid.org/0000-0002-6975-5044 Felix Amsler https://orcid.org/0000-0003-4259-7004 Correspondence address Erika Mendoza, PhD Venenpraxis Speckenstraße 10 31515 Wunstdorf Germany [email protected] . 2023 The Author(s) Distributed as a Hogrefe OpenMind article Vasa (2023), 52 (6), 423–431 under the license CC BY 4.0 (https://creativecommons.org/licenses/by/4.0) E. Mendoza & F. Amsler, Effect of MLD and IPC in lymphedema 431 https://econtent.hogrefe.com/doi/pdf/10.1024/0301-1526/a001090 - Wednesday, November 29, 2023 2:49:54 AM - IP Address:93.208.161.46
