management of lymphoedema

Last reviewed 05/2023

General treatment methods include:

    • educating the patient and family about the risk of developing lymphoedema and about the early detection of signs of oedema
    • skin and nail care - to reduce risk of skin infection
    • extremity positioning - elevation of the limb above the level of the heart when possible
    • exercise - nonfatiguing exercises may decrease swelling (1)

  • manual lymph drainage (MLD) - light massages which causes the lymphatic fluid to move away from the affected limb (2)
  • decongestive lymphatic therapy (DLT) or combined decongestive therapy (CDT) - includes a combination of compression bandaging, skin care and decongestive exercises. It reduces the pain and discomfort caused by lymphoedema (2)
  • diuretics are often prescribed for lymphoedema yet appear clinically unhelpful - there are no published trials related to the use of diuretics in this setting (2)
  • antibiotics are used if infection present
  • secondary lymphoedema requires specific therapy appropriate to the underlying disease
  • surgery - used in patients where non surgical treatment methods have failed (2):
    • most effective treatment of lymphoedema is complex decongestive therapy (3):
      • only 5% of patients with lymphoedema will be suitable for surgery
      • three main types of surgical procedure, liposuction, debulking operations and bypass procedure
        • liposuction has been used with promising results but mainly in arm lymphoedema
        • debulking operations
          • there are four well-known debulking procedures, Homan's, Charles, Servelle's and Thompson's. All give variable results and complications are common and serious
        • bypass procedures are undertaken only in specialised centres

Reference:

Related pages:

lymphoedema (treatment following breast cancer treatment)

liposuction for lymphoedema