PROCEDURES

Lymphedema Treatment

Definition

Lymphedema refers to swelling that generally occurs in the arms or legs when the protein rich lymph fluid is unable to drain properly. Lymphedema is caused by a blockage in your lymphatic system, an important part of your immune and circulatory systems. As the lymph fluid builds up the swelling continues resulting in pain, decreased mobility, recurrent soft tissue infections and even permanent disability.

Symptoms

• Swelling of part of your arm or leg, or the entire arm or leg, including your fingers and toes.
• A feeling of heaviness in arm or leg
• Restricted movement in your arm or leg
• Recurring infections in your affected limb
• Thickening of the skin on your arm or leg

Causes

Lymphedema can occur as an inherited condition caused by problems with the development of lymph vessels in your body. This congenital condition is known as primary lymphedema. Secondary lymphedema occurs when a condition or procedure damages the lymph nodes or lymph vessels. The most common injury is surgical when lymph nodes are removed for the treatment for a variety of cancers, such as breast cancer. If irradiation therapy to the area is necessary, the condition may worsen.

Treatments

Traditional treatment for lymphedema includes exercises, use of compression bandages and garments, and manual lymphatic massage. This type of treatment focuses on reducing the accumulation of lymphatic fluid within the soft tissue of the affected limb. Surgical treatment has shown some promising improvements in the symptoms of lymphedema. While there is no cure for lymphedema, a lymph node transfer may reduce the symptoms of lymphedema. Lymph nodes from the groin region can be microsurgically transferred to the arm with symptomatic lymphedema. One or two lymph nodes can be harvested in connection with a DIEP/SIEA procedure or as an independent procedure. The node is then transferred to the axilla. Blood flow is re-established to the lymph node by reattaching blood flow of the nodal vessels to the vessels in the axilla. Care is taken when transferring only one or two nodes from the donor site not to cause lymphedema in the region. Patients would then resume manual lymphatic massage and compression garments after the lymph node transfer.