Characteristics of chronic oedema
a) Swelling of >3 months' duration, which remains on elevation b) Positive Stemmer's sign (inability to pinch fold of skin at base of second toe due to thickening) c) Skin and tissue changes that may include:
a) Swelling of >3 months' duration, which remains on elevation
b) Positive Stemmer's sign (inability to pinch fold of skin at base of second toe due to thickening)
c) Skin and tissue changes that may include:
d) Tendency to bacterial and fungal infections
Problems associated with chronic oedema
Each individual with chronic oedema will experience different problems and the true impact of oedema on any one person cannot be predicted. This can be psychological distress as result of altered body image, difficulties with clothing and altered sensations are quite common. Lower limb swelling may have particular difficulties with footwear. Patients are often forced to resort to unsuitable, loose fitting shoes or slippers that compound their reduced mobility and as a result, may exacerbate a dependency oedema. Leakage of lymph from the skin are unsightly, distressing and further compromise skin integrity.
The management of chronic lymphoedema
The British Lymphology Society (BLS) has produced a document, that outlines four different groups within the chronic oedema population. The purpose of this document is to enable practitioners to determine the types of treatment and care required for different individuales. A 'Framework for Education', determining the educational needs of practioners managing patients in these different groups, has also been published.
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