The management of exudation in case of lymphedema

Aim

Lymphedema is not a rare disease. Worldwide about three percent of all people suffer from chronic lymphedema, the number of people with chronic lymphoedema worldwide is estimated to be at least 200 million.

Lymphedema can be defined as the accumulation of interstitial fluid caused by disturbed lymphatic drainage. The reduction in lymph flow can result from either congenital or acquired abnormalities in lymph drainage. Although lymphedema usually affects one or more extremities, it can also manifest in organs. Whatever the pathogenesis, it is often a chronic inexorable condition that poses a long-lasting and psychological problem for the patient and a complex therapeutic challenge for the physician.

Method

Wound, quality of life, photodocumentation, VAS; Zetuvit-Plus-Silicone®.

Results

In our supply we use Zetuvit-Plus-Silicone®. In addition to its high ability to absorb wound exudate during compression therapy, it is particularly easy to apply in difficult localizations and has good adhesion.

The secure containment keeps germ-laden and aggressive exudate away from the wound and its surroundings, thus reducing the risk of maceration and the resulting erysipelas and fungal infection. Due to the silicon-coated wound contact layer, the wound dressing does not stick to the wound, which enables atraumatic wound treatment and protection of the wound edges.

Conclusion

The permanent lymphostasis triggers a fibrotic remodeling of the tissue. Therapy should therefore start early. There are several factors to consider when treating patients with lymphedema. In addition to a low-salt diet and weight loss, manual lymph drainage and the wearing of special compression stockings and bandages are essential. Due to the massive leakage of lymph from the tissues, it can lead to maceration of the skin and later to the development of inflammatory wounds due to erysipelas and fungal infections. For this reason, good wound care is necessary. The treatment should be based on products that guarantee a high level of exudate management.

The comfort for the patient is particularly important here.

Clinical relevance

For patients with chronical wounds that involves a lot of exudation in case of lymphedema.

Acknowledgements

The Institute for Health Services Research in Dermatology and Nursing (IVDP)

John Schäfer
Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany

Myriam Seifert
Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany