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For further information please contact: Lymphoedema Service Tennyson Suite Skegness Hospital Dorothy Avenue Skegness PE25 2BS Tel: 01754 613515 Fax: 01754 760132 The Lymphatic System LCHS2016/17 -0022 Review Date November 2018 Macmillan Lymphoedema Service Lymph is a straw coloured fluid, which the body constantly produces within the tissues. Lymph carries away the waste products of the circulation. These waste products are then filtered through the two layers of the lymphatic network towards the neck where it drains back into the bloodstream, and then eventually passed out into the urine. There are two parts to the lymphatic network: • A superficial system which lies just beneath the surface of the skin • A deeper system of vessels and lymph nodes, which are found at key parts in the body. What Is Lymphoedema? Lymphoedema is a swelling that develops as a result of an impaired lymphatic system and the fluid is unable to drain from one or more areas of the body. It can affect any part of the body, but is most commonly seen in an arm or a leg. The swelling may be slight or large and it can cause various problems e.g.: skin changes, changes in sensation, loss of function and the feeling of distress. How does Lymphoedema occur? Some people are born without enough lymphatics to drain away the fluid. It may be that there has always been a problem with swelling, but sometimes, an injury or infection will make the oedema apparent. This type of lymphoedema is referred to as Primary Lymphoedema. A malfunction in the drainage can be caused by a problem outside of the lymphatic that prevents it from working properly. This could be following injury, infection, surgery, reduced mobility, problems with veins not working properly, radiotherapy or obesity. Cancer itself can also result in a blockage of the lymphatic system, although lymphoedema which occurs months or years after successful treatment for cancer does not necessarily mean that cancer has returned What is Chronic Oedema? Oedema occurs when fluid builds up in the tissues and causes swelling and has been present for more than 3 months. There are many different causes including: • Poor drainage of the lymphatic system • Poor function of the veins • Heart or kidney problems • Obesity: prevents lymph drainage • Lifestyle: legs being kept down with limited movement- eg. wheelchair use or sleeping in a chair at night. What is the treatment for Lymphoedema/ Chronic Oedema? Lymphoedema is a condition that cannot be cured, although it can be controlled. There are four elements of treatment, all of equal importance: ∗ Skin Care – to keep the skin in good condition and to reduce the risk of infections ∗ Exercise – to try and maximise lymph drainage without overexertion. ∗ Simple Lymphatic drainage – a gentle massage technique to try and move some of the swelling out of the affected area. ∗ Compression therapy ( bandages or garments/hosiery) – to help prevent the swelling build up within the limb Re-assessment and monitoring of progress is essential to ensure good results. It is also vital that patients help themselves. Lymphoedema is a chronic, long term condition that requires a high level of motivation and compliance by patients themselves. This is a team effort and the Lymphoedema team will support you to make changes and help you to monitor and manage your condition. Note: Not all Oedema or Lymphoedema is Cancer related. Adapted from the Lymphoedema Support Network Leaflet and British Lymphology Society Consensus Document