Compression therapy is used in the treatment of Lymphedema. An impaired lymphatic system leads to the swelling of a patient’s limbs due to fluid retention and tissue swelling. Lymphedema is not limited to the extremities; it can also affect the face, neck, genitalia, scrotum, e.t.c.

Causes of Lymphedema

There are two forms of Lymphedema: primary (hereditary)and secondary (acquired).

  • Hereditary
    It originates from a defect in the lymphatic system at birth. Studies show that 5 to 10% of patients suffering from primary Lymphedema have acquired the disease at birth.
  • Acquired
    Secondary Lymphedema
    develops when the lymphatic tissues are injured or are unable to perform their normal function. Lymphedema can be triggered by infections that harm or damage the lymphatic, immune system, such as those caused by insect bites, severe wounds, or burns. Being morbidly obese, undergoing surgery, suffering a severe injury, or being exposed to cancer radiation may bring up the disease. Up to 94.9% of lymphedema patients are believed to have secondary Lymphedema.
Factors that may promote the onset of Lymphedema or worsen existing cases
  • Surgical procedures, such as those used to treat cancer
  • A traumatic event that could harm the system
  • Chemotherapy and radiation therapy for cancer
  • Severe defects of the skin
  • Obesity
  • A persistent vein condition

Lymphedema symptoms

  • An asymmetrical swelling on the limbs caused by edema or congestion
  • Tightness in the chest or chest pains
  • Skin that is thick or firm depending on the lymphedema stage
  • Infections of the skin that don’t go away
  • Stemmer’s sign is positive when a skin fold at the hinge of the second toe and middle finger or any other swollen part of the body cannot be squeezed and grasped. The condition indicates advanced Lymphedema.
Lymphedema progresses through three distinct stages.
  • Stage 0
    There is no visible swelling despite reduced lymphatic transport and modest changes in tissue composition. It may take months or even years for edema to manifest.
  • Stage I
    The fluid accumulation in the afflicted limb decreases during this stage once it is elevated. There is an indentation where the damage occurred that disappears when the region is raised above.
  • Stage II
    Stage II denotes that elevating the limbs alone rarely helps minimize tissue edema. Pitting begins to be evident. The limb continues pitting as fibrosis develops and extra inner fat forms.
    Stage III
    Stage III lymphatic elephantiasis is characterized by trophic dermis changes like acanthosis, thickness changes, fat depositions, and overgrowths.

Complex Decongestive Treatment

CDT largely depends on Manual lymphatic drainage (MLD) and Compression Therapy

Manual lymphatic drainage is a technique used to increase lymph flow by applying light, rhythmic pressure and a series of circular motions.

  • Reduced Phase 1
    During the initial stage of CDT treatment, the focus is on minimizing fluid accumulation (reduction phase). Multi-layered bandaging performed by physiotherapists or medical practitioners must be changed daily, which is the norm for medical compression at this stage. Depending on the severity and current degree of Lymphedema, the initial CDT stage might last anywhere from 2 weeks to 6 weeks. Taking care of your skin is equally crucial.
  • Step Two: Maintenance
    The second stage of CPD is known as the maintenance phase, and its primary objective is to preserve and improve upon the volume decrease attained in the initial stage. Compression therapy using flat-knit compression garments, skin treatment, physical workouts, and as many repetitions of mechanical lymphatic drainage (MLD) as are deemed necessary as the mainstays of medical care.

Compression Therapy is Essential

Lymphedema compression therapy incorporates several different items. During the initial stage of CDT, the primary focus is on minimizing limb volume by using inelastic multilayer bandages. They can effectively treat even atypically formed limbs thanks to the intense compression they provide.

In the maintenance stage of lymphedema treatment, flat-knit compression stockings are the mainstay of treatment. If your limb volume is already stable, you should only apply this compression type. Flat-knit compression stockings can also help extremely shaped legs.

It is possible to employ wraps with hooks-and-loops shutters or brassiere hooks during the initial and secondary stages of CDT treatment. Wraps can be quickly put on or taken off. To accommodate the differences in limb volume, they may be adjusted to provide a range of compression levels.

Circular-knit compression hosiery is employed when the first phases of Lymphedema have not reached full capacity.

Using Mechanical techniques like intermittent pneumatic compression (IPC) to achieve the same results as manual lymphatic drainage (MLD). Truncal drainage is favoured and should only be utilized in cooperation with MLD. During IPC therapy, patients are confined to their seats by immovable equipment.

Importance of a Conventional Skincare Routine for People with Lymphedema

When lymph flow is constantly disrupted, protein-rich fluid accumulates in soft tissue, causing swelling and inflammation. The lymph system’s impairment also reduces the immune system’s efficiency.

Any cut, scrape, or abrasion on your arms or legs puts you at risk for infection and severe inflammation. Taking care of your skin’s health and any skin concerns will help prevent infections.

Wellness recommendations for people with lymphedema
  • Use compression garments when recommended by a physician.
  • Take care to shield the hurt limb. Avoid further injury to the injured limb, and take precautions against insect bites and sunburns by using insect repellent and high-factor sunscreen.
  • If feasible, the injured limb should not undergo medical treatments, including blood tests and immunizations.
  • Stretching, working out, and eating healthy are all recommended. Do not engage in intense activity until you fully recover from any incision or radioactivity treatment you may undergo.
  • Avoid exposing the injured limb to excessive temperatures.
  • Raise your limbs and elevate the wounded limb above your heart so that gravity can aid in lymph drainage.
  • If you wear a blood pressure cuff on your arm or tight clothing or jewellery on your leg, you could experience discomfort. Compression gear is intended to aid the body in expelling fluids. Tight clothing that digs in at the wrong spots could impede drainage.
  • Always wash and moisturize your leg or arm. Take special care of your nails and skin. Always look for skin changes or cuts that can lead to an infection. Wear shoes at all times to keep your feet safe.
  • Eat a healthy, balanced diet to keep your weight where it should be. Managing your body weight can lessen the severity of your symptoms.
  • Consuming lots of water aids in hydration and supports healthy kidney function, which is essential for eliminating excess water, protein, and other waste products.

The best way to reduce fluid retention is to eat less salt. Simple arm and leg motions (muscle pumping exercises) are helpful, especially when paired with external limb compression and other motions from daily life (walking, yoga, cycling, and stair climbing).

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