Managing the Lymphedematous Limb

Statement of the Problem:     Lower extremity wounds represent significant medical and financial challenges in health care. Wounds can significantly limit a patient's mobility impacting negatively their social, psychological, physical, and economic quality of life.  Undiagnosed swelling may lead to severe skin breakdown and wounds susceptible to infection that can damage the lymphatic system leading to lymphedema. Affected individuals are upset because of their perceived abandonment by their healthcare provider. 
Rationale:     Clinicians with direct patient contact are in an excellent position to recognize the risk factors for wounds but need to be aware of the signs of a lymphedematous limb. Due to the stagnation of the lymph fluid resulting from lymphatic disruption and the pooling of lymph fluid, differentiating between etiologies of wounds can lead to the implementation of an effective treatment plan.
Methodology:       Discussion of  three case studies and the elements of a comprehensive complex lymphatic therapy program, including, but not to:
·         Volume Measurements
·         Skin/Wound Assessment and Care
·         Manual lymph drainage
·         Compression Therapy
·         Decongestive Exercises
·         Patient Education
Result:     Patients diagnosed with lymphedema with severe skin alterations and/or wounds underwent a comprehensive lymphedema treatment program.  The wounds and skin alterations healed, tissue health improved, lymphedema was managed, and quality of life was significantly enhanced.
Conclusion:    Coping with the effects of lymphedema can be a most daunting battle.  There is need to develop treatments to meet the complicated needs caused by this condition.  Although lymphedema has been recognized for over a century, understanding its causes and treating the bio-psycho-social needs of the individual has received limited attention but can provide remarkable life altering outcomes.