Lymphoedema

Lymphoedema

What is lymphoedema?

Lymphoedema is an abnormal, chronic swelling of a body part/s caused by a collection of lymphatic fluid in the tissues below the skin. It occurs when there is a dysfunction in the lymphatic system.

Types of lymphoedema

Primary lymphoedema occurs when the lymphatic vessels or lymph nodes have not completely developed or have developed abnormally before birth.

Secondary lymphoedema occurs as a result of damage to or obstruction of the normal lymphatic system, resulting in an inability of the lymphatic system to transport lymph back into the circulatory system. This may be caused by trauma or surgery, venous insufficiency, a blood clot (post-thrombotic syndrome), cancer (as a side-effect of radiotherapy/surgery for cancer or the tumour itself), obesity, untreated wounds or infections amongst others.

Signs and symptoms

  • Fullness or a heavy sensation of the body part
  • Painless or painful swelling
  • Tightness in the skin
  • Difficulty wearing clothes or shoes
  • Longstanding swelling causes skin changes, eg inflammation, thickening, dryness, discolouration, eczema. These changes may lead to cellulitis (skin infection) and ulceration

Lymphoedema is a chronic condition which is progressive if left untreated. There may always be a tendency to swell, but it can be managed well with the correct treatment and lifestyle modification. Early diagnosis and treatment will ensure the best possible outcome.

It is important that a venous contribution is excluded as this can be treated and the outcome optimised. (Link to Venous Oedema)

The recommended treatment for lymphoedema is called Complete Decongestive Therapy (CDT). This is performed by a certified lymphoedema therapist working actively with the patient and aims to reduce swelling, then maintain the optimal size and health of the limb with well-fitting, carefully selected compression garments.

The components of Complete Decongestive Therapy are:

  • Manual lymphatic drainage therapy
  • Multi-layered compression bandaging and wound care if required
  • Meticulous skin and nailcare
  • Compression garments
  • Rehabilitative exercises to improve lymphatic function, fitness, strength and general health as required
  • Self-management with the ongoing support of the treating Dr, lymphoedema therapist and the rest of the multi-disciplinary team

The above picture shows multi-layered compression bandaging

The above picture shows a patient before and after the intensive phase of complete decongestive therapy – the left leg is reduced to optimal size and will be maintained with life-long compression garments