Promoting importance of lymphedema therapy

1. Shivangi Dave, MS,OTR/L, CLT

2. Lymphatic system
Components & Functions
Components of Lymphatic System:
 Lymph vessels
 Lymph nodes
 Spleen
 Thymus gland
 Tonsils
 Lymphocytes

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

4. Lymph Vessels
Re: Kublik Re: Weissleder

5. Lymphatic drainage
Picture: Kublik

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

13. Does it work?
Pictures: Providence St. Peter Hospital,
Lymphedema Clinic, Olympia, WA

14. Short Stretch bandaging &
MLD (CDT)
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

18. Questions ?