Wound Care

190 Nurse to Nurse
MANAGEMENT AND TREATMENT 8,12
OF LYMPHEDEMA
• No known cure at this time
• Treatment may delay or prevent disease progression
• Surgery such as lymphovenous shunt (occasionally used for
severe cases but not usually treatment of choice)
• Nonsurgical treatments
— Antibiotics for active infection
— Antibiotics may also be used prophylactically in individuals
with frequent infections
— Benzopyrones (Coumarin NOT Coumadin); these are not
anticoagulants (they are benzopyrones) and are not commonly
used in the United States
Benzopyrones aid in removing excess protein and
therefore reducing edema by causing an increase in
macrophages in the area
This approach is slow (takes months)
º Educate patients to take oral doses (topical medication
not used in US) with food. Side effects include
dizziness, drowsiness, nausea, or diarrhea usually in
the first month of use.
— Complex physical decongestive therapy (CPDT), complex
physical therapy (CPT), or complex lymphedema therapy
(CLT)
— Four components to these therapies 6,11
Decongestion or manual lymph drainage (MLD): gentle,
daily massage and physiotherapy to improve lymph flow
Compression therapy to prevent reaccumulation of fluid;
done by tightly wrapping limb after each MLD session
When maximal reduction in edema is achieved (often
after 1 month or longer) patient is fitted with compression
garment that requires custom fitting and is often
custom-made