Lymphedema: The affected limb requires special care!

Author: Wang Tingting, head nurse at Beijing Century Altar Hospital, Capital Medical University

Reviewer: Xu Lili, Chief Physician, Beijing Zhongguancun Hospital

Lymphedema is a circulatory disorder caused by various reasons, which causes lymph fluid to be retained in the tissue space, leading to a series of pathophysiological changes such as edema, chronic inflammation, and fibrosis.

For patients, the care and management of patients needs to start from several aspects:

First, evaluate the affected limb. How to evaluate? Observe the affected limb every day to see if there are signs of infection such as redness, swelling, heat, pain, etc. Check whether the skin is dry, whether it needs moisturizing, whether there are ulcers, and whether there are mosquito bites.

Second, measure regularly. We all know that patients with chronic diseases, such as hypertension and diabetes, need to monitor their blood pressure and blood sugar regularly. In fact, the same is true for patients with lymphedema, who also need to monitor the affected limb. How to monitor? For professionals, bone landmarks are used for measurement and judgment, but this method is more difficult for patients. Patients can find a position that they think is easy to grasp, and pay special attention to a fixed position of the affected limb, such as the ankle, or a point on the calf, or a point on the thigh root. For example, measure once every half a month or a month to have an understanding of your affected limb and detect abnormalities in time.

Figure 1 Original copyright image, no permission to reprint

If the edema of the affected limb is found to be worse recently, we can analyze it ourselves to see if we have been tired recently, walked a lot, or had an infection before, or the elastic stockings are not suitable, so we can adjust them by ourselves first. Or if we have gained weight recently, such as 20 pounds, the legs will inevitably become thicker. Therefore, we hope that patients can monitor and care for the affected limbs through this method, so that they can know what is going on. After eliminating the interference factors that they know, if the edema still progresses significantly, it is recommended to go to the hospital for treatment.

Third, care of elastic stockings and elastic sleeves: patients should be familiar with the models of elastic sleeves and elastic stockings they wear, and adjust them according to the thickness of the affected limbs. For example, due to erysipelas recently, the limbs are swollen again. Are the original socks too tight and can they still be worn? Or if the maintenance is good recently, the edema has subsided a little, and the legs have become thinner, should the model of elastic stockings be changed? Also, if the elastic stockings feel less elastic recently, do you need to re-measure and customize a pair, etc. Because if the elasticity of the elastic stockings decreases, it will not have a good restraint function on the limbs and cannot maintain a good treatment effect. It should be noted that once erysipelas occurs, it is not recommended to wear any pressure products. You should immediately seek medical attention for anti-inflammatory treatment, and wear elastic sleeves and elastic stockings after the acute period.

Generally, the service life of elastic sleeves and elastic socks is half a year to one year. That is, when they are worn, they can be washed when they get dirty like clothes. However, care should be taken when washing. Generally, they are required to be washed by hand in warm water below 40°C, and not in a washing machine. Also, neutral detergent should be used, not laundry powder. In addition, they should not be exposed to the sun and should be laid flat in a cool place to dry.

Figure 2 Original copyright image, no permission to reprint

You can't wash them with hot water because some elastic sleeves and elastic socks contain rubber. Hot water will cause the rubber to age and affect its service life. It is generally recommended that you buy two and wear them alternately. If you find any damage or deterioration in elasticity, replace them in time.

Fourth, daily care of the affected limb: patients should cut their nails frequently in daily life, but do not cut their nails too bald to avoid damaging the stratum corneum and causing bacteria to invade and cause infection. Avoid mosquito bites. If the affected limb itches, do not scratch it to avoid scratching the skin surface. Avoid soaking your feet or taking a bath in overheated water, avoid steaming in the sauna, etc. For patients with upper limb lymphedema, do not hold children with the affected limb, do not lift or carry weights of more than 2kg, prohibit repetitive actions such as mopping the floor and cutting vegetables, do not wear tight clothing, and avoid wearing tight rings, necklaces and other accessories. Patients with lower limb edema should avoid sitting or standing for a long time. They can do some actions like stepping on a sewing machine to promote blood circulation. It should be noted that pressure products must be worn during activities.

In addition, do not perform invasive procedures on the affected limb, such as blood drawing, injections, including blood pressure measurement, etc. When patients go to the hospital for other diseases, they should actively inform the medical staff to avoid invasive procedures on the affected limb.

Fifth, prevent infection. If you have onychomycosis, athlete's foot, etc., you must seek timely treatment to avoid the formation of erysipelas, because erysipelas will cause greater harm to patients with lymphedema.