Lymphedema is localized fluid retention that is caused by inadequate drainage of lymph fluid. Typically lymphedema affects the limbs, but may affect other areas. The lymphatic system is a collection of blood vessels, similar to veins, that drain extravascular fluid from areas of the body and return this fluid into the circulation via the veins. The poor lymph drainage causes collection of extravascular fluid and a firm swelling of the affected limb (arm or leg).
The lymph vessels can be injured in many ways, including by trauma, radiation, surgery, or inherited conditions. In North America, lymphedema commonly affects patients after a radical dissection as part of cancer treatment, since lymph nodes and vessels are commonly removed. In some tropical areas, a parasitic infection called filiriasis can cause lymphedema.
Lymphedema may cause severe fatigue, a heavy swollen limb, localized firm swelling in other body areas, skin discoloration and skin ulceration. Over time, lymphedema can lead to limb deformities known as elephantiasis. It is often initially misdiagnosed, as other forms of lower limb swelling are much more common. Lymphedema can cause impaired quality of life and also be disfiguring.
A significant complication of lymphedema is soft tissue infection. Affected areas contain large amounts of protein, which bacteria use as fuel to grow. Soft tissue infections in lymphedema patients can be very hard to treat, and can lead to limb loss.
The treatment for lymphedema involves mechanically decompressing the lymph system of the affected area, as usually there is no cure for the underlying process. This involves exercise, which maintains muscle strength and helps promote lymph drainage. Gradient compression documents or short stretch bandages are used, both of which compress the affected area. The gradient causes more compression on the end of a limb, and less closer to the body, in order to promote lymph flow out of the limb. Finally, a form of massage therapy, called manual lymphatic drainage, is used regularly to promote lymph drainage. It is thought that gentle manipulation of the skin and subcutaneous tissue opens lymph channels, leading to improved drainage.
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