Lymphedema diagnosis and management

PURPOSE: To provide advanced practice nurses with a greater understanding of the pathophysiology, clinical manifestations, diagnosis, and management of lymphedema. DATA SOURCES: Comprehensive literature review of the relevant clinical journals, systematic reviews, and medical textbooks. CONCLUSIONS: Lymphedema is a poorly known and understood condition. If not properly diagnosed and promptly treated, lymphedema can cause significant morbidity and mortality. Diagnosis is based on suggestive history and characteristic findings on physical exam that ideally would be confirmed by lymphoscintigraphy. The primary goal in lymphedema treatment is the removal of excess plasma proteins from the interstitial tissues. The goals of management are to decrease the extremity size, maintain the decreased size, prevent complications, and improve function and overall sense of psychological well-being. IMPLICATIONS FOR PRACTICE: The ability to properly diagnose lymphedema is crucial to prevent the significant morbidity and mortality that is associated with this condition. It is imperative that patients with lymphedema are referred to specially trained healthcare professionals to ensure optimal treatment.