3. Lymphatic system
Components & Functions
Functions :
Transports proteins and fluid from
the tissues to cardiovascular
system
Transports fat from intestinal
lymph vessels to cardiovascular
system
Has important immunological
functions
Re: Benjamin Cummings
6. What is Lymphedema?
Lymphedema is the swelling
of a body part(s), most often
arm(s) or leg(s) as a result of
lymphatic failure.
It is an abnormal
accumulation of proteins in
the body’s tissue ( unlike
dependent edema).
Over the period,
lymphedema causes tissue
proliferation of the affected
areas.
Re- compressionstore.com
7. Types of Lymphedema
Primary lymphedema-
Born with insufficient or compromised lymphatic system
Secondary lymphedema-
May be a result of : Surgery and/or radiation for cancer,
Cancer, Filariasis, Trauma, Infection, Chronic Venous
insufficiency or Obesity
8. Signs and Symptoms of
Lymphedema
Swelling starts gradually and may be preceded by a
feeling of heaviness or fullness in the affected area
Rings, bracelets, clothing or a watchband may feel
tighter than normal
Pitting Edema
Decreased ROM/ mobility
Recurrent cellulitis infections
9. Early detection and lowering risk
for Lymphedema
Educate about lymphedema- “ spread the word”
Specialized clinicians can diagnose on the basis of clinical
examination
Early assessment of unilateral UE Lymphedema with use of
L-DEX
Eat healthy and strive to be as normal body weight as
possible
Be active and exercise; if uncertain about the right kind of
exercise, check with your CLT
10. Management of Lymphedema
Complete Decongestive Therapy (CDT) as the method of
choice- includes two phases
Decongestion phase
Maintenance phase
Blue indicates Phase I
= intensive phase
Green indicates Phase II = maintenance phase
Re-FÖLDI M., FÖLDI E., KUBIK S., Textbook of Lymphology
11. Components of CDT
Manual lymphatic drainage (MLD)
Compression Bandaging
Exercise
Skin and nail care
Instructions in self care
12. About MLD
• lymphatic uptake
• lymph vessel pulsation
• Promotes movement of fluid from
edematous areas to regions
of normal lymphatic drainage
• Promotes relaxation
• Analgesic effect
Re-klosetraining.com
15. Compression garments
Essential after decongestive treatment
Custom Made vs. Ready to Wear Garments
Various compression grades and styles
Flat knit, circular knit, cut & sew
Prophylactic benefit
Proper compression grade
Ensure good fit
Re-klosetraining.com
16. References
Textbook of Lymphology by M. Foeldi, E. Foeldi, S. Kubik (EDS.)
Urban Fisher Verlag, 2003
ISBN: 0-9729535-0-7
Lymphedema Diagnosis and Therapy by H. Weissleder, Ch.
Schuchhardt, 3rd Edition, Viavital Verlag, 2001
ISBN: 3-934371-24-8
A Primer on Lymphedema by Deborah Kelly, Prentice Hall, 2001
ISBN: 0-13-022410-3
Modern treatment of lymphoedema (5th ed.) by Casley-Smith J.R. &
Casley-Smith J.R.(1997). Adelaide Australia: The Lymphedema
Association of Australia
Introduction and Treatments for Lymphedema by Sabrina S. Selim,
BA, Francine Manuel, RPT, Cheryl Ewing, MD, Ernest Roseenbaum,
MD
www.medsalsupplier.com/lymphguide.html
Additional Website Links at: www.klosetraining.com
17. Infrastructure for Lymphedema Program
Private Room- to make patients feel comfortable
Hi-Low Table -to make therapist comfortable
http://www.pattersonmedical.com/app.aspx?cmd=getProduct&key=IF_921022485
http://www.pattersonmedical.com/app.aspx?cmd=getProduct&key=IF_97701
Disposable gowns/Medical gowns -
http://www.pattersonmedical.com/app.aspx?cmd=getProduct&key=IF_921020678
Disposable Gloves
Arm bandages
Compression garments- need to find local resources/fitters
Eucerin/ Aquaphor
Micropore Tape
Bolster
Hoyer lift if legs to be treated
With lymphedema elevation does not decrease swelling and diuretics do not help, but can actually make it worse.
Anatomical locations- extremities, truncal, genitals, head neck face
Skin changes, weakness, fluid drainage from skin, numbness, psychological distress
L-DEX use of low frequency impedance to assess and monitor unilateral LE
A simple way to view impedance data
Comparison to normal range.
The ImpTM XCA uses the L-Dex (Lymphoedema Index) for assessment of unilateral lymphoedema of the arm. The normal range for an L-Dex value for patients without lymphedema is between -10 to +10.
The normal range for L-Dex was established from bioimpedance data gathered from a cross population study of healthy women [1]. The mean (average) L-Dex value of healthy women without lymphedema is defined as 0.0 within this normal range
MLD has the effect of extending the lympho-lymphatic anastomoses interconnecting the different lymph territories and allowing lymph to be transported through watersheds into edema free territories.
When patients cooperate fully with phase II of CDT, especially wear their compression garments at all times, they can virtually lead normal life.
