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These notes give an overall guide to your stay in hospital. You may see some differences in the details of your treatment, since it is tailored to suit your own condition.
WHAT IS LYMPH?
This is the fluid that oozes out of the blood vessels into the tissues of the body. It is the fluid that causes one's ankles to swell - for instance when sitting for a prolonged time in an aircraft.
Lymphatics
These are small vessels which drain away the lymph. These lymph vessels coalesce into larger and larger channels. They pass through the glands, which are congregated densely in some areas, particularly in the groins and under the arms. It is infection carried in these lymphatic channels and filtered out by the glands which causes these glands to be tender during periods of infection.
If the lymph channels are not working correctly for any reason then lymph can build up in the tissues, which become swollen. This presents commonly as swelling of the feet, ankles and legs as well as other parts of the body. When this occurs there is a feeling of tightness and discomfort. There is also a greater tendency to infection, which may settle in these swollen areas. The swelling is referred to as oedema. The infection in this tissue under the skin or subcutaneous tissue is called cellulitis.
The lymphatics may function poorly for many reasons. These vary from there being too few lymphatics either because too few were developed or because of damage to the lymphatics. Damage may occur for many reasons including injury, infection, surgery or x-ray treatment.
Treatment
If there are too few lymphatics or if the lymphatics have been damaged it is impossible to reverse this. Treatment is concentrated upon improving the drainage of the lymph from the limb thus reducing the swelling. It must be remembered that lymphoedema is a chronic condition and that continued care over many years is required. The tendency for the fluid to drain poorly and collect in the subcutaneous tissues will always be there.
TREATMENT CONSISTS OF :
1. Elevation
Gravity will always assist in the drainage of lymph from the limbs thus elevation always helps. The foot of the bed should be slightly raised about 4 to 6" so that gravity has an effect during sleep.
2. Elastic compression
An elastic stocking gives external support and compression aiding in the drainage of the lymph and controlling the swelling. It is important that this elastic compression is worn at every available opportunity.
3. Infection
Because of the previously mentioned risk of infection it is very important to pay particular attention to any skin damage or infection. Infection should be avoided at all costs and if it occurs it needs prompt and effective treatment.
4. Massage
Massaging the limb in the direction of flow of the lymph helps drainage.
5. Exercise and weight control
These are all-important facets of treatment and none should be used in isolation. The important thing is to use every opportunity to minimise the chronic collection of fluid.
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