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Lymphedema is an accumulation of protein-rich fluid in the
tissue space in the body. This accumulation causes swelling. Lymphedema
most often affects the arms and legs. There are two types of lymphedema,
primary and secondary.
Primary lymphedema may be due to a congenital malformation
or the absence of lymphatics. It can develop in adults without any obvious
cause.
Secondary, or acquired, lymphedema is more common. It can occur
as a result of surgery, radiation, trauma, or infection.
Many types of cancer require the removal of lymph nodes. Anytime
lymph nodes are removed or damaged, patients are at risk for developing
lymphedema. Lymphedema may appear days, weeks, or even years after cancer
treatment. Other conditions, such as post-surgical edema and congestive
heart failure, can also lead to lymphedema if left untreated.
The Treatment Process
Manual lymph drainage/complete decongestive therapy is a noninvasive,
highly effective treatment for lymphedema. Generally, treatment is made
up of two phases:
Phase I
- Manual lymph drainage (MLD)
- Compression bandaging
- Skin care
- Remedial exercises
Treatment is usually done five times per week for four to six
weeks, depending on severity. Throughout phase I treatment, education
plays a major role in helping the patient progress and preparing the
patient for home management. The patient and family are taught self
MLD, bandaging, limb size monitoring, and compression garment guidelines,
all of which are necessary to maintain or improve the results achieved
in phase I.
Phase II
- Self MLD as needed
- Compression garment daily, bandaging at night as needed
- Skin care
- Continued exercises
- Lifelong management
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