Weeping leg ulcers

adrienurse, LPN · Nov 26, 2003

Just found out that it was probably caused by the fact that one of the T.E.D stockings had been missing for a few days and she had gone without on her affected leg. Grr, how easy would it have been just to order another pair from stores?

5150dx · Jan 24, 2004

Hello,

Please realize there is a big difference in protocols for treating Lymphedema (either primary or secondary) versus edema caused by cardiac "issues".

Diuresis as a treatment to reduce Lymphedema is absolutely contradicted because though it dehydrates the fluid buildup it leaves the remaining interstitial fluid even more concentrated with protein which makes infection, fibrosis formation and other complications even more likely.

Lymphedema is mostly seen in patients who have undergone surgery which either removed or damaged a region of lymph glands -- commonly seen with breast cancer pts. Others are secondary to severe burns or radiation treatments. Still a few more were born with missing or malfunctioning lymph vessels and organs -- this would be Primary Lymphedema.

Please take a look at this website: http://www.lymphnet.org/ and remember there are a growing number of nurses, physical therapists and doctors who have undergone specialized training for this problem and are certified to do so. Also beware of some massage therapists who claim to do "lymph massage" -- this has nothing to do with the medically oriented and clinically proven Manual Lymph Drainage combined with Complete Decongestive Therapy which these patients need.

CDT will include the Manual Lymph Drainage with restorative exercise, skin and nail care of the affected limb, compression bandages throughout the initial treatment and then the professional fitting of compression garments to keep the lymphedma in check. The patient will also be educated about caring for the limb, including, but not limited to, not allowing invasive procedures to be performed on it (ie: blood draws, injections, blood pressure cuff, and more).

The use of mechanical compression devices is becoming rapidly more controversial because of its ability to actually damage the lymph vessels, among other things.

Kristin