Lymphedema

Lymphedema is a condition characterized by swelling of the soft tissue of the limbs, or less often the trunk, caused by a buildup of lymph fluid. Of the two types primary lymphedema is less common. Primary lymphedema is the term used for this swelling when the cause is not obvious. Primary lymphedema is most often seen in children due to genetic makeup. Symptoms appear at anytime but most often the onset is at puberty. Secondary lymphedema is more common and the result of injury to the lymphatic system. The onset of secondary lymphedema may be triggered by tumor, surgery, radiation, trauma, deep vein thrombosis, or chronic infection as seen in venous ulcers. Many of these cases are mild. However, early lymphedema management will often prevent more severe edema and minimize complications. Adequate lymphedema management may prevent complications that could lead to disability and disfigurement.

Lymphedema management includes correct differential diagnosis and treatment. Treatment objectives are to: control and decrease swelling, stabilize and prevent progression, prevent infection, improve quality of life.

Treatment options vary from simple measures such as limb elevation above the level of the heart, to mechanical devices such as the lymphedema pump. Other important treatment components include exercise, weight loss, physical therapy, antibiotics (in cases where infection is present), Diuretics (cautiously), lymphatic sleeve, or pneumatic sleeve.

The lymphatic sleeve, an elastic sleeve bandage, is applied two times daily. The pressure of the sleeve forces fluid back into the lymphatic system. The pneumatic sleeve operates on the same principle, but the air filled sleeve pump sequentially massages the limb thereby returning fluid to the lymphatic system. Lymphedema pumps are available in a wide variety of sizes and can be customized for individual needs.

Without treatment swelling will increase range of motion will decrease. There can be disfigurement. Infection becomes a possibility as skin integrity becomes compromised. Local infection may lead to sepsis. Often problems are possible such as cellulites, vascular dysfunction, chronic ulceration, necrosis, gangrene, and amputation.