Protecting Lymphedema Patients During Surgery

Introduction

Tissues affected by lymphedema, or at risk of developing it, must be carefully protected during surgical procedures. If you need surgery, it is important that your surgeon, and all members of the surgical team, understand the risk and these protective steps.

As the patient, it is your responsibility to inform your surgical treatment so they understand your special needs. This article contains the basic information you will need and you are welcome to use it for this purpose.

The Risk

• Patients with Stage 1 lymphedema are 1,000 times greater risk of developing a surgically related infection than are individual without this risk.
• Patients with Stage 2 lymphedema are at 27 times greater risk than those at stage 1.
• Patients with Stage 3 lymphedema are at 72 times greater risk than those at stages 1 or 2. [1]

Guidelines to Protect "at Risk" Patients [2]

• Before your surgery, have your surgeon consult with the patient’s lymphedema therapist concerning lymphedema risks during and after the surgery. This would be include having the patient wear a compression garment during surgery. Also by arranging to have the therapist perform Manual lymph drainage (MLD) before and after the surgery.
• Identify which patients have lymphedema, or at risk of developing it. A pink color coded band is often used for this purpose. Your hospital should have a protocol and be trained to should follow it!
• Antibiotics administration. Lymphedema affected patients are at very high risk of infection and antibiotic administration should be planned to lower this risk.
• Blood pressure readings on an affected limb must be avoided. A blood pressure cuff can alter, or damage, lymphatic function within the area. When the patient is transferred from the OR to recovery, never allow the blood pressure cuff to be transferred to the” at risk” arm.
• Avoid any injection, blood draw, arterial stick, or finger prick in the affected limb. These procedures break in the skin can lead to an infection.
• Avoid any IV placement in the affected limb. This breaks the skin and, if the medication leaks out of the blood vessel, this can further irritate these tissues.

Labeling Your "At Risk" Limb

There are steps that the patient can take to be certain that their "at risk" limb is clearly identified.

References

[1] Lymphedema Management: The Comprehensive Guide for Practitioners 2nd Edition by J.E. Zuther. Thieme 2009, pages 91-95.

[2] Lymphedema Caregiver’s Guide by M. K. Kearse PT, CLT-LANA, E. McMahon PhD, and A. Ehrlich MA. Lymph Notes 2009.

[3] Perioperative Guidelines for Surgery on the Edematous Limb by W. Farrow, MD. Lymph Link, Vol 19, No 4, Oct-Dec 2007.  

© LymphNotes.com 2011.This information does not replace the advice of a qualified health care professional.

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Category: Living With Lymphedema Updated: 2011-08-24