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Lymphoedema and Chronic Oedema

Who is the service for?

The Macmillan Lymphoedema and Chronic Oedema Service is for people who have had swelling of any body part for more than 3 months which is not relieved by elevation of the limb or over night. The service is also for people who have been treated for cancer and notice swelling following treatment.

About Lymphoedema

Lymphoedema is an accumulation of lymphatic fluid in the tissues, which produces swelling of the affected area, often arms, legs or other body parts.

Lymphoedema can occur because of a poorly functioning lymphatic system, which may cause swelling from birth/childhood, from adolescence, or onset may be in adult life. This is called primary lymphoedema.

Lymphoedema may develop because of damage caused to the lymphatic system. This is called secondary lymphoedema. Damage may be caused by surgery, especially when lymph nodes have been removed, by cancer treatment, such as radiotherapy, by infections or after thrombosis and after veins have been removed in the legs for heart surgery.

People with paralysis or dependent limbs can also develop chronic oedema/lymphoedema. People who have had swollen legs for a long time may develop a combination of venous/lymphoedema.

Aims of the service

The service aims to:

• provide a Lymphoedema/Chronic Oedema service for patients in Islington.
• promote Lymphoedema management in the community.
• reduce complications such as cellulitis and leaking legs.
• identify patients at risk of developing Lymphoedema and educate to reduce risk.
• improve healthcare professionals' knowledge of lymphoedema management.
• promote trust guidelines for the treatment of cellulitis in Lymphoedema.

How treatment can help

• Lymphoedema is incurable but treatable. Untreated lymphoedema generally worsens leading to less mobility often causing anxiety and depression.
• The risk of infection/cellulitis is very high in patients with lymphoedema. Infection often causes further damage to the lymphatic system. Long-term antibiotics may be necessary to control infections and sometimes hospital treatment may be necessary.
• The aim of the treatment is to reduce swelling and to control lymphoedema long term, which improves mobility and quality of life.
• The reduction of the swelling reduces the risk of infection.
• Early treatment usually gives better reduction in swelling.
• The cooperation of the patient and/or carer are essential for successful treatment.

What treatment does the service offer?

• Initial assessment to determine the most appropriate treatment.
• Skin care to achieve good skin conditions and prevent infection.
• Compression/support - compression hosiery or lymphoedema bandaging to reduce, then control oedema.
• Exercise programme to promote lymph flow with muscle pump activity.
• Manual lymphatic drainage - a gentle form of massage to move fluid to an area.
• Simple lymphatic drainage where lymphs drain normally.
• Regular monitoring which is essential for effective management of the condition.

Where are patients seen?

Partnership Primary Care Centre
331 Camden Road
London N7 OSL

This is opposite the Holloway Prison.
Bus - 29, 253, 91, 259, 17, 393

Bingfield Primary Care Centre
8 Bingfield Street
London N1 OAL

Bus 17, 91, 259, 274

Both Primary Care Centres have disabled access. Home visits are available if necessary.

What is the waiting time for this service?

The waiting time is currently 2 weeks.

How to access the service

Please ask your GP, nurse or other health care professional to refer you to the Lymphoedema/Chronic Oedema service.

Further information

Lymphoedema Support Network
www.lymphoedema.org/lsn

British Lymphology Society
www.thebls.com