What is lymphedema?
An abnormal collection of protein rich fluid in the interstitium, which causes chronic inflammation and reactive fibrosis of affected tissues.
Why do we need to treat lymphedema?
What are the key principles of lymphoedema management?
- Skin and nail care
- Positioning and exercises
- Massage therapy (MLD, SLD)
- Bandaging (MLLB)/ compression garments
How to take Skin and Nail Care?
- Apply gentle soap with luke warm water
- Apply coconut oil / moisturizing lotion
- Clean all injuries immediately
- Avoid injection to the swollen limb
- Avoid tight clothing
- Avoid jewelry
- Avoid rubbing
What is the Aim of skin care?
To prevent skin infection
How to do the Positioning?
- Limb elevation by using 2-3 pillows
- Limb should be straight and above heart level
- Avoid crossed legs
What are the different types of exercises?
- Active and passive range of movements, strength and stretching
- Low exertion, slow rhythmical and gentle with rest period
- Diaphragmatic breathing 10 times before MLD/SLD
- Arm and leg exercises
How does positioning and exercises help?
- Breathing exercises increases volume of lymph fluid transported through thoracic duct
- Increases muscle and joint pump
- Increases lymph vessel activity
- Increases venous and lymphatic return.
How does MLD (manual lymphatic drainage) help?
- Improves lymph circulation
- Increases lymphatic contractions frequency
- Stimulates resorption of protein
- Breaks down fibrotic areas
- Reduces pain- promotes relaxation
How the multi-layer bandaging do helps?
- Reduces the ultrafiltration rate
- Improves efficiency of muscle and joint pumps
- Prevents reacumulation of evacuated lymph fluid
- Helps break up deposits of accumulated scar and connective tissue
Summary of instructions to patients
- Skin and nail Care
- Infection prevention
- Self MLD as required
- Wearing and removal of compression garments
- Follow up visits