Post on 17-Jan-2017
LymphedemaTreatment & Management
Shivangi Dave, MS,OTR/L, CLT
Lymphatic systemComponents & Functions
Components of Lymphatic System:
Lymph vesselsLymph nodesSpleenThymus glandTonsilsLymphocytes
Lymphatic systemComponents & FunctionsFunctions : Transports proteins and fluid
from the tissues to cardiovascular system
Transports fat from intestinal lymph vessels to cardiovascular system
Has important immunological functions
Re: Benjamin Cummings
Lymph Vessels
Re: Kublik Re: Weissleder
Lymphatic drainage
Picture: Kublik
What is Lymphedema?Lymphedema is the
swelling of a body part(s), most often arm(s) or leg(s) as a result of lymphatic failure.
It is an abnormal accumulation of proteins in the body’s tissue ( unlike dependent edema).
Over the period, lymphedema causes tissue proliferation of the affected areas. Re- compressionstore.com
Types of LymphedemaPrimary lymphedema- Born with insufficient or compromised lymphatic system
Secondary lymphedema- May be a result of : Surgery and/or radiation
for cancer, Cancer, Filariasis, Trauma, Infection, Chronic Venous
insufficiency or Obesity
Signs and Symptoms of LymphedemaSwelling starts gradually and may be
preceded by a feeling of heaviness or fullness in the affected area
Rings, bracelets, clothing or a watchband may feel tighter than normal
Pitting EdemaDecreased ROM/ mobilityRecurrent cellulitis infections
Early detection and lowering risk for Lymphedema Educate about lymphedema- “ spread the word”Specialized clinicians can diagnose on the basis of
clinical examinationEarly assessment of unilateral UE Lymphedema
with use of L-DEX
Eat healthy and strive to be as normal body weight as possible
Be active and exercise; if uncertain about the right kind of exercise, check with your CLT
Management of LymphedemaComplete Decongestive Therapy (CDT) as the
method of choice- includes two phases Decongestion phaseMaintenance phase
Blue indicates Phase I = intensive phase
Green indicates Phase II = maintenance phaseRe-FÖLDI M., FÖLDI E., KUBIK S., Textbook of Lymphology
Components of CDTManual lymphatic drainage (MLD)Compression BandagingExerciseSkin and nail careInstructions in self care
About MLD
• lymphatic uptake• lymph vessel pulsation• Promotes movement of fluid
from edematous areas to regions of normal lymphatic drainage • Promotes relaxation• Analgesic effect Re-klosetraining.com
Does it work?
Pictures: Providence St. Peter Hospital, Lymphedema Clinic, Olympia, WA
Short Stretch bandaging & MLD (CDT)
Re-klosetraining.com
Compression garmentsEssential after decongestive treatmentCustom Made vs. Ready to Wear Garments
Various compression grades and styles Flat knit, circular knit, cut & sew
Prophylactic benefit Proper compression gradeEnsure good fit
Re-klosetraining.com
ReferencesTextbook of Lymphology by M. Foeldi, E. Foeldi, S. Kubik
(EDS.) Urban Fisher Verlag, 2003 ISBN: 0-9729535-0-7
Lymphedema Diagnosis and Therapy by H. Weissleder, Ch. Schuchhardt, 3rd Edition, Viavital Verlag, 2001
ISBN: 3-934371-24-8A Primer on Lymphedema by Deborah Kelly, Prentice Hall,
2001 ISBN: 0-13-022410-3
Modern treatment of lymphoedema (5th ed.) by Casley-Smith J.R. & Casley-Smith J.R.(1997). Adelaide Australia: The Lymphedema Association of Australia
Introduction and Treatments for Lymphedema by Sabrina S. Selim, BA, Francine Manuel, RPT, Cheryl Ewing, MD, Ernest Roseenbaum, MDwww.medsalsupplier.com/lymphguide.html
Additional Website Links at: www.klosetraining.com
Infrastructure for Lymphedema ProgramPrivate Room- to make patients feel comfortableHi-Low Table -to make therapist comfortable
http://www.pattersonmedical.com/app.aspx?cmd=getProduct&key=IF_921022485http://www.pattersonmedical.com/app.aspx?cmd=getProduct&key=IF_97701
Disposable gowns/Medical gowns - http://www.pattersonmedical.com/app.aspx?cmd=getProduct&key=IF_921020678
Disposable GlovesArm bandages Compression garments- need to find local
resources/fittersEucerin/ Aquaphor Micropore TapeBolsterHoyer lift if legs to be treated
Questions ?