Lawenda BD, Mondry TE, Johnstone PA. Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment. CA Cancer J Clin. 2009; 59:(1)8-24

Poage E, Singer M, Armer J Demystifying lymphedema: development of the lymphedema putting evidence into practice card. Clin J Oncol Nurs. 2008; 12:(6)951-964

Stout NL, Brantus P, Moffat C. Lymphoedema management: an international intersect between developed and developing countries. Similarities, differences and challenges. Glob Public Health. 2012; 7:(2)107-123

Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med. 2003; 44:(1)43-57

Morgan PA, Franks PJ, Moffatt CJ. Healthrelated quality of life with lymphoedema: a review of the literature. Int Wound J. 2005; 2:(1)47-62

Bunke N, Brown K, Bergan J. Phlebolymphemeda: usually unrecognized, often poorly treated. Perspect Vasc Surg Endovasc Ther. 2009; 21:(2)65-68

Akita S, Mitsukawa N, Kuriyama M Suitable therapy options for sub-clinical and early-stage lymphoedema patients. J Plast Reconstr Aesthetic Surg. 2014; 67:(4)520-525

Maclellan RA, Couto RA, Sullivan JE Management of primary and secondary lymphedema: analysis of 225 referrals to a center. Ann Plast Surg. 2015; 75:(2)197-200

Keast DH, Despatis M, Allen JO, Brassard A. Chronic oedema/lymphoedema: under-recognised and under-treated. Int Wound J. 2015; 12:(3)328-333

Hodgson P, Towers A, Keast DH Lymphedema in Canada: a qualitative study to help develop a clinical, research, and education strategy. Curr Oncol. 2011; 18:(6)e260-264

Morgan PA, Murray S, Moffatt CJ, Honnor A. The challenges of managing Continued page S15 complex lymphoedema/chronic oedema in the UK and Canada. Int Wound J. 2012; 9:(1)54-69

Moffatt CJ, Franks PJ, Doherty DC Lymphoedema: an underestimated health problem. QJM. 2003; 96:(10)731-738

Tidhar D, Hodgson P, Shay C, Towers A. A lymphedema self-management programme: report on 30 cases. Physiother Can. 2014; 66:(4)404-412

Oremus M, Dayes I, Walker K, Raina P. Systematic review: conservative treatments for secondary lymphedema. BMC Cancer. 2012; 12

Gethin G, Byrne D, Tierney S Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic. Int Wound J. 2012; 9:(2)120-125

Sitzia J, Woods M, Hine P Characteristics of new referrals to twenty-seven lymphoedema treatment units. Eur J Cancer Care (Engl). 1998; 7:(4)255-262

Teo I, Munnoch DA. Referral patterns to a surgical lymphoedema service: 10 years of experience. J Plast Reconstr Aesthet Surg. 2015; 68:(10)1395-1401

Williams AE, Bergl S, Twycross RG. A 5-year review of a lymphoedema service. Eur J Cancer Care (Engl). 1996; 5:(1)56-59

Sierla R, Lee TS, Black D, Kilbreath SL. Lymphedema following breast cancer: regions affected, severity of symptoms, and benefits of treatment from the patients' perspective. Clin J Oncol Nurs. 2013; 17:(3)325-331

Hareyama H, Hada K, Goto K Prevalence, classification, and risk factors for postoperative lower extremity lymphedema in women with gynecologic malignancies: a retrospective study. Int J Gynecol Cancer. 2015; 25:(4)751-757

Farrow W. Phlebolymphedema-a common underdiagnosed and undertreated problem in the wound care clinic. J Am Col Certif Wound Spec. 2010; 2:(1)14-23

Prevalence and characteristics of lymphoedema at a wound-care clinic

02 September 2020
Volume 4 · Issue 4



Lymphoedema is estimated to affect up to 300,000 Canadians but remains under-recognised and undertreated. A retrospective chart review was conducted to determine the clinical characteristics and treatment practices of lymphoedema in a Canadian wound care clinic.


Data were collected retrospectively from dictated clinic notes of 326 lymphoedema patients at a wound clinic in a regional rehabilitation hospital.


The mean age (±SD) of diagnosis was 66.8 (±15.5). Patients had 7.3 (±3.3) comorbidities and took 8.4 (±4.6) concomitant medications. The most common comorbidities were venous disease (73%), hypertension (60%), and obesity (46%). Clinic patients were less likely to be women, have arm lymphoedema, or have cancer-related aetiology compared with previous studies, reflecting a two-tiered model of care delivery in the area. Treatments prescribed by the clinic were consistent best practice recommendations for conservative treatment.


A significant proportion of the wound clinic's patients had lymphoedema. Lack of resources, lack of awareness among primary care providers, and patient adherence are barriers to lymphoedema care.

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

Register now to continue reading

Thank you for visiting Wound Central and reading some of our peer-reviewed resources for wound care professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Access to clinical or professional articles

  • New content and clinical updates each month