Lymphedema is the swelling and buildup of lymph fluid in an obstructed or compromised lymphatic system. A patient with lymphedema should be knowledgeable about multiple lymphedema safety factors. Lymphedema can be a lifelong, non-fatal disease with no cure. Untreated lymphedema can lead to cellulitis, elephantiasis, and even lymphangiosarcoma, a rare cancer of the lymphatic system. Adhering to lymphedema safety factors will prevent detrimental effects to a patient's health.
Avoiding Constriction
Lymphedema often occurs in limbs. It is a buildup of lymph fluid in the arms or legs. A patient with lymphedema should always avoid having her blood pressure taken in the swollen limb. The high pressure applied in the cuff will lead to a tourniquet effect, which constricts blood and lymph flow in an area. The tourniquet effect will harm the already poorly functioning lymphatic system in the limb. This may lead to increased swelling and lymph constriction in the limb. Lymph fluid would pool outside the area of the blood pressure cuff, leading to two areas of ballooning in the limb.
The patient should also avoid constricting, tight clothing, jewelry, and bandages.
Maintaining Skin Hygiene
When a patient has lymphedema, he is likely to develop fungal or bacterial infections on his skin if he has poor hygiene. He should shower or bathe daily and keep the skin moisturized with lotions or creams that have a low pH formula. Low pH formulas are acidic, which prevents the growth of fungus or bacteria on the skin.
The patient should avoid cuts, burns, and injury to the skin and limb, along with manicures that involve cuticle cutting. He should treat pimples and superficial cuts on the skin immediately. Wash any wound with soap and water and apply antibacterial creams. Good hygiene will prevent cellulitis, an infection of the skin which may require hospital intravenous antibiotics to treat. Skin infections, cuts, and wounds may worsen lymphedema.
Avoiding Heat
Heat dilates vessels in the body. A patient with lymphedema should avoid extended periods in the heat, heating pads, sun burning, and hot water. Heat leads to increased swelling in the body, worsening the lymphedema in the affected limb. Ice packs may not increase swelling; however, it may also not help decrease lymphedema.
Wearing Compression Garments
A patient with lymphedema should avoid vigorous exercises or weight lifting without wearing a well-fitting compression garment. Exercising increases swelling in the limb. Without the added external pressure of a compression garment, the condition of the limb with lymphedema may worsen. Well-fitting compression garments should be snug and comfortable. They provide graduated-pressure, meaning the same amount of pressure throughout the limb. This avoids a tourniquet effect. When a garment is well-fitting, there will be no pooling of lymph fluid in the limb.
Another instance when a patient with lymphedema should wear a compression garment is when he travels by plane. According to the National Lymphdema Network Guidelines, "Individuals with a confirmed diagnosis of lymphedema should wear some form of compression therapy while traveling by air. The guidelines say people should obtain a good-fitting garment well in advance of the trip and wear it several times to ensure proper fit and comfort. For most upper extremity lymphedema conditions compression of at lease 20-30 mmHg is recommended in the guidelines and for most lower extremity lymphedema conditions, compression of at least 30-40mmHg is recommended.
A hand piece, either a glove or a gauntlet should be worn with the compression sleeve.
Place the garment on before take-off, and leave it on for oned to three hours after deplaning to allow tissue pressures to equilibrate.
