Lymphedema Services

MILLIKEN PROVIDES LYMPHEDEMA SERVICES

Refer a patient or schedule an appointment: 314-286-1669

What is Lymphedema?

Lymphedema presents as a chronic swelling of the limb due to the accumulation of protein-rich fluid. This can be due either to a genetic condition or as a result of trauma or cancer. It may cause a significant increase in limb size, an increase in susceptibility to infection, and may also impact healing ability. As lymphedema progresses, changes in your skin composition may occur.

Lymphedema can be managed with therapy, compression garments, and when appropriate- surgical intervention. 

Signs and Symptoms

• Swelling
• Tightness of the skin
• Feeling of heaviness, fullness, or fatigue in the limb
• Aching pain
• Hardening of the skin
• Reduced range of motion

Risk Factors

Risk factors include radiation to your lymph nodes or removal of lymph nodes.

Treatment:

What to expect on your first day of therapy:

Following your evaluation, the first day of treatment will consist of preparing bandaging supplies and Manual Lymph Drainage (MLD). You will be asked to remove your clothing during treatment so massage is directly over your skin. Sheets will be used to ensure privacy. You are welcome to bring a family member or friend to therapy with you.

Your first set of bandages will be provided to you by your therapist. If a second set is required, it will be your responsibility to purchase these bandages.

What to wear:

Loose-fitting shirt (preferably short sleeves or a tank top)

The goal

The goal of therapy is to achieve maximum swelling reduction. This is accomplished with a combination of bandaging, MLD, and a possible exercise plan. Bandages will need to be worn for 22-24 hours a day over the course of therapy. Your therapist will discuss specific guidelines with you.

Course of treatment

In general, therapy will begin with treatment sessions 4-5 days a week. This can vary based on diagnosis and presentation. After two weeks, your treatment will be reduced to 2-3 times a week as appropriate. When limb reduction is achieved, you will be measured for compression garments. These typically arrive 1-2 weeks after the order date. Your therapist will ensure proper fit upon arrival. These garments will be used long term.

We recommend a follow-up every 6 months.

Care of Bandages

Bandages should be washed frequently. You will need to follow the care instructions provided. In general, bandages need to be washed a minimum of once a week in lukewarm water. Use a mild liquid detergent with no softeners. Items should be washed by hand or in a lingerie bag if using the washing machine. Lay bandages flat to dry. Stockinette can be machine washed and air-dried.

Do not wash any foam pieces or padding.

Finger wraps do not have a long life – usually, one to two wears only. These should not be washed.

Please roll the bandages after washing so that they are ready for the next use.

If bandages cause an increase in pain, rubbing, throbbing, discoloration, numbness, or tingling that does not resolve with repositioning the limb, remove the outermost bandage. If symptoms continue, remove all bandages and contact therapists.

Reducing the Risk of Infection

Lymphedema can be worsened with infection. It is important to protect your skin and practice good hygiene. You can reduce your risk of infection by following these tips:

• Keep your skin clean, dry, and moisturized
• Do not cut your cuticles
• Protect your skin with sunscreen and bug spray
• Avoid constriction and punctures to the affected limb (such as blood draw and blood pressure cuffs)
• If damage to the skin occurs, care for the wound and use antibacterial ointments as indicated.

If significant redness, warmth, or pain occurs in any area of your skin, especially when combined with fever or flu-like symptoms, contact your physician immediately.

Refer a patient or schedule an appointment: 314-286-1669

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Central for Advanced Medicine location

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Washington University and Barnes-Jewish Orthopedic Center location