Lymphedema of the extremities.

Lymphedemas of the extremities are a worldwide problem. Whereas in tropical countries damage to the lymphatics by filarial diseases is the major source of lymphedemas, in developed countries, lymphedema due to a lymphatic blockade in the course of treatment or trauma is the most common cause. Conservative treatment plays a major role in the treatment of lymphedemas. However, lifelong therapy is advocated. Surgical therapy can be divided into three categories: resec-tional, diverting, and reconstructive procedures. In the case of a locally interrupted lymphatic pathway, bypassing the defect using the patient's own lymphatic vessels may normalize the lymphatic outflow of an extremity and therefore provide the chance for a cure and for becoming free from lifelong therapy.