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Lymphedema and Wound Care

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Pearls and Pitfalls in Skin Ulcer Management

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Abstract

Lymphedema is a chronic condition characterized by an abnormal collection of fluid (lymph) in the interstitial space. It is secondary to a lymphatic system that is anatomically either incompletely formed or often disrupted by cancer and its surgical treatment. The complications of lymphedema are secondary to the high protein content in the interstitial fluid. Indeed, the persistent increase of protein and its degradation products results in chronic inflammation, fibrosis, and adipose tissue deposition. Profound inflammation of skin and soft tissues can result in dramatic permanent cutaneous changes that lead to the physical distortion of the affected limb. Moreover, high protein oedema becomes the underlying pathology that contributes to the formation of venous ulcers.

Wound care clinical trials consistently confirm that correction of the underlying factor(s) leading to the chronic ulcer formation (edema) is more important than the choice of topical dressing and is the intervention most essential to effecting healing. Notwithstanding this premise, current dressing principles based on appropriate cleansing routine, moist wound care, periwound area protection, and contaminant avoidance apply also to the wounds of a lymphedematous limb. Control of exudate usually represents the primary challenge, making absorbency perhaps the most important functional aspect of wound dressings.

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Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Precision and Regenerative Medicine and Jonic Area, University of Bari, Bari, Italy

    Rossella Elia & Michele Maruccia

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  1. Rossella Elia
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  2. Michele Maruccia
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Editors and Affiliations

  1. Unit of Plastic and Reconstructive Surgery, Department of Precision and Regenerative Medicine and Jonic Area, University of Bari, Bari, Italy

    Michele Maruccia

  2. Plastic Surgery Unit, University of Trieste, Cattinara Hospital, Trieste, Italy

    Giovanni Papa

  3. Difficult Wound Healing Unit, Policlinico di Monza, Vercelli, Italy, Italy

    Elia Ricci

  4. Plastic and Reconstructive Surgery, University of Bari Aldo Moro, Bari, Italy

    Giuseppe Giudice

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Elia, R., Maruccia, M. (2023). Lymphedema and Wound Care. In: Maruccia, M., Papa, G., Ricci, E., Giudice, G. (eds) Pearls and Pitfalls in Skin Ulcer Management. Springer, Cham. https://doi.org/10.1007/978-3-031-45453-0_53

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  • DOI: https://doi.org/10.1007/978-3-031-45453-0_53

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