Prevalence and characteristics of lymphoedema at a wound-care clinic

Lymphoedema is a chronic, debilitating condition arising from the accumulation of protein-rich fluid buildup in the skin. Primary lymphoedema is caused by malformed or absent lymphatics.¹ Secondary lymphoedema has a variety of causes, including infection, chronic venous insufficiency, obesity, trauma, surgery, and immobility.^1,2 Multiple factors may contribute to the underlying lymphatic dysfunction that leads to the development of lymphoedema. The most common cause of secondary lymphoedema worldwide is lymphatic filariasis affecting over 150 million people worldwide primarily in sub-Saharan Africa and Southern Asia. In developed countries, the most common aetiology is thought to be cancer treatment and/or its treatment.³

Regardless of aetiology, lymphoedema causes significant physical and psychosocial morbidity. Untreated lymphoedema can lead to recurrent infections, hospital admissions, and deformity of the affected limb.⁴ Reduced quality of life and employment difficulties have also been reported.⁵ The chronicity of the condition, for which there is no cure, may also be a source of frustration for patients. Management may include meticulous skin care, exercise, manual lymphatic drainage (MLD), a specialised form of massage, and compression therapy. Of these, the key treatment is compression therapy, which must be kept up indefinitely to be effective.^6,7