Today's Wound Clinic - Winter 2008 - (Page 28) coverstory Patient Tips for Living with Lymphedema and Lipedema Susan Gallagher Camden, RN, MSN, WOCN, PhD; Tere Sigler, PT, CWS, CLT I n the presence of lipedema, chronic venous insufficiency, or lymphedema, the skin is usually dry and fissures easily, creating a susceptibility to cellulitis and other types of infection. The following are tips wound care professionals can provide to their patients. CLOTHING Encourage the patient to avoid tight or restrictive clothing that impairs circulation or causes irritation, skin scratches, or swelling. Shoes with low heels are recommended especially if lower leg edema exists. Jewelry such as watches, anklets, bracelets, and finger or toe rings should not fit tight or rub against the skin surface. SKIN PROTECTION Keep skin protected with daily use of a mild cleanser and lotion that are free of alcohol or fragrances. Explain to the patient that bathing water should be warm but not hot. Avoid irritating cosmetics, detergents, deodorants, or perfumes. Use sunscreen and insect repellent regularly. The affected area should be inspected daily for any changes such as discoloration, temperature, texture variation, and pain. Any of these together or separately should be reported to the primary care provider. ACTIVITIES A skilled clinician may recommend activities suited to the patient’s unique needs, abilities, and resources. One strategy is to implement an appropriate program that assists the muscular system in moving lymphatic fluid out of the affected area. Because avoiding injury and overexertion in the affected area are important, low- or no-impact activities are best. Increased weight complicates lymphedema. Moderate exercise such as swimming, walking, biking, and core strengthening are some options. High impact sports, heavy weightlifting, and aggressive contact activities should be avoided. DIET The patient should maintain a balanced diet of fruit, vegetables, whole grains, and proteins. Excessively fatty foods, sweets, alcohol, and salt should be avoided. Encourage consumption of plenty of water and unsweetened beverages. PROCEDURES According to some literature, treatment procedures such as diuretics and surgery should be considered with caution. Diuretics will initially decrease the water content and reduce swelling but the protein molecules remain in the tissues and swelling will recur as soon as the drug loses its effectiveness. All medications should be discussed with the clinician. ■ 28 Winter 2008 Today’s Wound Clinic
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