Lymphoedema

Summary for patients:

Lymphoedema occurs when a clear fluid known as lymphatic fluid builds up in the soft tissues of your body, usually in your arm or leg, causing swelling and making it vulnerable to infection. It can be inherited (Primary Lymphoedema) or caused by an injury to your lymphatic system (called Secondary Lymphoedema). The affected area of the body has to work much harder to circulate fluid, so wearing a compression garment helps lymph drainage and prevents additional swelling.

For healthcare practioners:

The function of the Lymphatic system is to take excess fluid from the interstitial tissues and return it to the venous system. Lymphatic fluid is made up of water, protein, white blood cells, cell debris and other nutrients.¹

Lymphoedema is a progressive chronic condition which manifests itself in one or more of the limbs and is categorised as being either Primary or Secondary depending on the aetiology.

Primary lymphoedema is used to describe hereditary genetic lymphoedema and usually manifests itself from birth (Milroy’s disease) or at the onset of puberty (Lymphoedema praecox) and is due to a congenital malformation of the lymphatic system.²

Secondary Lymphoedema is usually due to damage or trauma to the lymphatic system i.e treatment for cancer (radiotherapy, chemotherapy), overload of the lymphatic system due to Chronic Venous Insufficiency, burns or cardiac disease.^3,4

Lymphoedema is not yet curable but can be managed with the appropriate treatment.⁵

References

1. Lymphoedema bandaging in practice :EWMA Focus Document 2005
2. Dale RF. The inheritance of primary lymphoedema. J Med Genet 1985; 22(4): 274-78
3. Moffatt CJ, Franks PJ, Doherty D, et al. Lymphoedema: an underestimated health problem. QJM 2003; 96: 731-38.
4. Hardy D, Taylor J. An audit of non-cancer-related lymphoedema in a hospice setting. Int J Palliat Nurs 1999; 5: 18, 20-27.
5. Best Practice for the Management of Lymphoedema 2006