The Lymphedema Program at Wellington Regional Medical Center
Lymphedema is an accumulation of lymphatic fluid in the interstitial tissue of the body that causes swelling, most often in the arms or legs. Lymphedema can develop when lymph vessels are missing, impaired, damaged or when lymph nodes are removed. The lymphatic system is the body’s drainage system responsible for immune defense and the return of substances from the interstitial space back into the blood circulatory system. Disturbance in the lymph transport system often leads to edema or lymphedema. Primary and Secondary Lymphedema Lymphedema is a serious condition because of the long-term physical and psychosocial consequences for patients. If lymphedema is left untreated it will continue to progress. There are two types of lymphedema: primary and secondary. Primary lymphedema represents developmental abnormalities of the lymphatic system, usually congenital or hereditary. Secondary lymphedema is usually due to a mechanical insufficiency. Some causes are surgery, radiation, trauma, infection, tumors, immobility and chronic venous insufficiencies.
The Three Stages of Lymphedema
- The first stage is considered reversible with symptoms characterized by edema with no secondary tissue changes. At this stage, elevation of the affected limb reduces swelling.
- Stage two, known as the spontaneous irreversible stage, is characterized by lymphatic fibrosis, hardening of the tissues, positive Stemmer sign and frequent infections.
- Stage three, known as lymphatic elephantiasis, is characterized by an extreme increase in the volume of interstitial fluid and change in tissue texture including papillomas, deep skin folds and a positive Stemmer sign.
Management of Lymphedema Lymphedema is a progressive disease process which can be easily managed by Complete Decongestive Therapy (CDT). CDT focuses on restoring and optimizing the lymphatic system by combining four components: manual lymphatic drainage, compression therapy, decongestive exercises and skin care. Manual Lymphatic Drainage (MLD) is a type of massage that assists in opening lymphatic channels, mobilizing lymph fluid and softening fibrotic tissues. This technique, when combined with compression bandaging, produces a decompression and emptying of the lymphatic channels that ultimately decrease edema in the affected limb. Exercise can also be effective in decreasing lymphedema in the involved limb. During the course of treatment, patients will learn self-MLD, self-bandaging, proper skin care and application of compression garments. When these treatment parameters are consistently utilized, patients will notice their results by a reduction of lymphedema and the ability to resume activities of daily living. The Lymphedema Program at Wellington Regional Medical Center offers comprehensive lymphedema intervention. All therapists are certified lymphedema specialists.