Miscellaneous procedures
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha in Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
Lymphoedema, also known as lymphedema and lymphatic oedema, is a condition whereby localised fluid retention causes tissue swelling due to a compromised lymphatic system. In the normal lymphatic system interstitial fluid returns to the bloodstream. Imaging using radioactive substances may be used to confirm or negate the presence and site of lymphoedema. For lower limb studies the patient is injected with 99mTc-nanocolloid into the first webspace of both feet. If the upper limb lymphatics need to be imaged the nanocolloid is injected into the first web space of both hands. The examination is a safe, well-established, and minimally invasive technique for assessing lymphatic drainage in limbs for lymphoedema. This section is based on the BNMS 2011 professional guidelines [50].
Conservative Treatment of Lymphedema
Waldemar L. Olszewski in Lymph Stasis: Pathophysiology, Diagnosis and Treatment, 2019
Physician—The physician has to be a specialist in internal medicine with an adequate training in oncology, physical medicine, and lymphology. Concerning the latter, this necessitates at least 2 years of internship in a clinic specialized in lymphedema treatment. Before starting CPT, a thorough checkup is mandatory. Any disease diagnosed in addition to lymphedema has to be treated in an adequate manner. The three pillars of CPT—massage, bandages, and remedial exercises—are administered individually. It is up to the physician to prescribe them to the physiotherapist and it is up to him to prescribe the compressive stockings/sleeves too; they vary from patient to patient. Last but not least, he has to check the elastic stockings furnished by the manufacturer by observing them during wear. Mistakes are by no means rare and must be repaired.
Vulvar cancer and post-vulvectomy complications
Miranda A. Farage, Howard I. Maibach in The Vulva, 2017
The management of lymphedema includes conservative and surgical treatment. In general, the management of lymphedema is focused on conservative treatment, which is based on externally enhanced lymphatic drainage. Such methods include compression therapy, elevation of the affected limb, decongestive physiotherapy (by specific manual lymphatic drainage massage), and external sequential pneumatic compression (75). The conservative treatment of lymphedema has showed success mainly in patients with mild to moderate lymphedema and is associated with great variability due to its dependence on patient compliance (76). As a result, a large number of patients experience little benefit from this type of treatment (70). Furthermore, the external physical methods can be costly, uncomfortable, and time consuming (77,78).
The effectiveness and safety of heat/cold therapy in adults with lymphoedema: systematic review
Published in Disability and Rehabilitation, 2023
J. E. Hill, J. C. Whitaker, N. Sharafi, O. Hamer, A. Chohan, C. Harris, A. Clegg
With no cure for lymphoedema, attention has focused on conservative management approaches to managing its symptoms, specifically through improving the flow of fluid through the lymphatic system and preventing its build-up [46]. Guidance has recommended the wearing of active or passive compression garments, multilayer bandaging, exercise, and specialised massage techniques (e.g., manual lymphatic drainage) to help promote the drainage of fluid and prevent it accumulating in the body [47]. The importance of good skin care to prevent infection is emphasised [47]. Surgery to debulk tissue through liposuction and lymphatic reconstruction through bypass provide other options [47]. Although temperature-based treatments have been used with the intention of improving drainage of lymphatic fluid [48], current clinical advice given to people with lymphoedema indicates that extremes of temperature should be avoided [16,49–51]. It is thought that such extremes may increase blood flow and increase lymphatic load [15]. Uncertainties around possible treatment options cause concern for people with lymphoedema and for those providing treatment who want to receive and provide the most effective care [52].
Impact on Health-Related quality of life after wearing compression garment or not for six months in women with mild breast cancer-related arm lymphedema. A cross-sectional study
Published in Acta Oncologica, 2023
Katarina Y. Blom, Karin I. Johansson, Lena B. Nilsson-Wikmar, Pia E. Klernäs, Christina B. Brogårdh
In the practical domain, more participants in the CG rated a negative impact on HRQOL regarding employment activities compared to the NCG, which indicates that it may be a problem for some patients. In many occupations, of hygienic reasons, it is difficult to wear a compression sleeve and even more difficult to use a glove. Individualized counseling about strategies on how to use the compression garment during work/household activities may be helpful and could probably improve HRQOL. For example, the use of night compression [20] can compensate for part of the day when the patient finds it difficult to use compression. To improve adherence and optimize compression treatment it is important to apply a person-centered approach and ask about the patient’s own experience and consider the possible negative impact on HRQOL in relation to the preventive effect. The compression treatment should also be evaluated regularly to ensure that the lymphedema is not over-or under-treated.
An important tool in lymphedema management: validation of Turkish version of the lymphedema breast cancer questionnaire
Published in Disability and Rehabilitation, 2022
Hanife Doğan, Hanife Abakay, Ayşe Güç, Halit Karaca
In the diagnosis of lymphedema, the concepts of heaviness and swelling are especially focused on [9]. Each question in the LBCQ reflects a separate symptom. When looking at symptom percentages, patients with lymphedema reported higher rates of symptoms compared to those without lymphedema. In the literature, it has been reported that 10–60% of the patients experience at least one upper extremity problem (pain, numbness, tingling, stiffness, edema, weakness, or reduction in joint range) within a period of 6 months to 3 years after surgery [26]. In our study, the most common symptoms encountered by individuals with lymphedema were a heaviness, swelling, increased temperature, stiffness, and the development of fluid buildup. These results contribute to clinical and empirical studies regarding the symptoms researchers should focus on most in detecting lymphedema.
Related Knowledge Centers
- Edema
- Exercise
- Extracellular Fluid
- Manual Lymphatic Drainage
- Parasitic Disease
- Lymphatic System
- Immune System
- Infection
- Circulatory System
- Genetic Disorder