Lymphedema Management – A Clinical Approach
Highlights on Medicine and Medical Science Vol. 17,
22 July 2021
Background: Lymphedema is a chronic lymphatic system condition characterised by reduced lymphatic return and swelling of the affected area. Despite the fact that it is a significant cause of morbidity, little is known about the epidemiology and impact of this illness on patients or health systems. Management of lymphedema primarily aims at reducing or halting progression of swelling and to prevent associated infection. The condition is treated with a combination of moisturisers and emollients, compression bandages, isotonic exercise, and regular massage. The idea of stimulating lymphatic drainage with external physical means has a good physiological basis. However, given the lack of proof on relative effectiveness of approaches now available, relying on a single strategy alone is improbable.
Objective: The aim of the study was to study lymphedema clinically and institute treatment accordingly and study the outcome of same.
Methods: The study comprised 33 patients who presented with lymphedema at a plastic surgery department. Congenital lymphedema patients were not included in the study. Each patient's treatment was adapted to their specific needs. At 1, 3, 6, and 9 months, patients were assessed for the efficacy of the treatment they had started. Complex decongestive physiotherapy (CDP), the use of elasto-compressive bandages, and multi-layered lymphedema bandages (MLLD), as well as limb elevation, attentive skin care, and remedial physiotherapy, were all used in the treatment.
Results: There were 12 males and 20 females among the 33 patients. Upper-extremity lymphedema affected 11 patients, lower-extremity lymphedema affected 21 patients, and scrotal lymphedema affected 1 patient. Conservative treatment, Pneumatic Compression, Complex Decongestive Physiotherapy (CDP), or Miller's Debulking Procedure were all used on the patients. Both volumetric assessment and patient satisfaction were considered to assess the outcome of treatment. Necessary changes were done in the treatment thereafter.
Conclusion: Lymphedema is a debilitating disease that affects the patient's physical and mental well-being. The patient should also be involved in the management. The patient's psychological needs should also be addressed. Treatment should be individualised to the individual, and changes should be made as needed. In the absence of a definitive therapy, a holistic approach will be used.
- chronic oedema
- complex decongestive physiotherapy
- manual lymph drainage