Lymphedema Management

Janet Wolfson's picture
patient treatment

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

Long ago, in a Physical Therapy Department far away, I met my first lymphedema patient, but did not know that was the cause of her recurring wounds. Into the next decade, I treated more patients with chronic swelling in their legs and we put something called Unna boots on them. But the boots did not work for everybody. By the end of the decade, there were layered compression wraps and I had started to see courses for therapists in manual lymphatic drainage. Hmmm, curious…

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Temple University School of Podiatric Medicine's picture

By Bradley W. Lind and James McGuire DPM, PT, CPed, FAPWHc

Venous leg ulcers are a type of lower extremity wound complicated by excess fluid production, periwound edema, and high bioload produced by venous insufficiency often leading to secondary lymphedema. The Coban™ 2 Layer Compression Therapy System, created by 3M Health Care, was designed to achieve sustained therapeutic compression, while improving the ease of application, and reducing slippage of the dressing during wear. The reduction in layers of the dressing also allows the patient to wear their own footwear and avoid the purchase of a surgical shoe.

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Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Lymphedema can be defined as swelling of one or more limbs which may also include a portion of the corresponding trunk. Lymphedema can also affect the breast, head, neck or genitalia. It occurs when fluid and other components such as protein accumulate in the tissue spaces as a result of a disparity between the creation of interstitial fluid and its transport or movement. It may be caused by damage to the lymphatic system (i.e., as a result of cancer treatment) or as the result of a congenital malformation of the lymphatic system. It is a chronic condition with no cure, but it can be managed if diagnosed early on.

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Michael Miller's picture

em>By Michael Miller DO, FACOS, FAPWCA


There are many colloquialisms we use to describe a variety of situations. When someone appears to make a real commitment, we call it “full bore” or “going whole hog” or to use the gambling epithet, “all in”. Commitment is an important part of what we as health care practitioners stand for. You have all read ad infinitum, ad astra, ad mortem of my strongest belief that patients must take an equal role in their care. We provide the recommendations, the rationale and the risks (and benefits, of course) and they decide which of our offerings best suits their beliefs, their desires and for better or worse, their purses. The marketing profession has made millions of consumers purchase items they do not need based on the sex appeal of the turn of a phrase, changing a question of doubt into “iron clad”.

Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA


I have always had a penchant for the ironic. I love a great joke well told, an amusing anecdote well written or a cartoon well drawn. Charles Addams, creator of the Addams family in the New Yorker magazine introduced his “unusual” family by drawing them poised several stories above and looking down upon a group of happy, singing Christmas carolers as they prepared to pour boiling oil on them. I still chuckle when I think about it. I love unusual sayings such as “You have a firm grasp of the obvious”, “You may not be good, but at least you’re slow” or “I can’t see the forest because of the trees.”

Thomas Serena's picture

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

One of the greatest honors of my life was being inducted into the Athletic Hall of Fame at The College of William and Mary. I was a gymnast there during my college days, a sport I chose early in life. My first loves were basketball and football, but I was always either too small or too light to play these sports competitively for my school teams. Even on the playground I was frequently chosen last in basketball pick-up games. To this day I remain sensitive to team picking. I recently received a call from a physical therapist looking to join my wound care team. Her hospital had enlisted the services of a management company that had marginalized the role of physical therapy in the outpatient wound care center.

WoundSource Editors's picture

by the WoundSource Editors

Lymphedema (alternate spelling: lymphoedema) is a condition marked by the retention of interstitial fluid (lymph) and the swelling (edema) of surrounding soft tissue, often affecting the extremities. It is also referred to as lymphatic obstruction.

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