The diagnosis and treatment of lymphedema

Abstract

Lymphedema is not uncommon, but it can often be undiagnosed until discomfort or complications occur. It tends to develop slowly, but is progressive without proper treatment. Lymphedema occurs when the lymphatic fluid load is greater than the ability of transport, resulting not only in excessive accumulation of tissue fluid but also in deformity of appearance, immobility, and more serious consequences. Stage I lymphedema can be improved by simply promoting drainage with elevation and compression garments. Stage II or III lymphedema should be managed intensively with complete decongestive therapy using a combination of skin care, exercise, elevation, manual lymph drainage, intermittent pneumatic compression, multilayer lymphedema bandaging and weight reduction. The safety and effectiveness of other treatment modalities for lymphedema such as liposuction, microsurgical lymphatic reconstruction, needle aspiration, stem cells, laser therapy, and iliac vein stenting should further be investigated. Since lymphedema is progressive, the diagnosis and treatment of lymphedema at the earliest possible stage is very important. Complete decongestive therapy is principal, and psychosocial support is an important element of the treatment of lymphedema. © Korean Medical Association.