lymphedema Lymphedema is mainly caused by the obstruction of lymphatic fluid reflux in certain parts of the body, leading to an abnormal increase of fluid in the interstitial spaces and resulting in localized tissue swelling. Due to the deposition of lipids, lipid sclerosis, and abnormal proliferation of subcutaneous fibrous connective tissue, in the later stages, it can lead to thickening, roughness, and toughness of the skin, hence also known as "elephantiasis." It commonly occurs in the lower legs, upper arms, genitalia, and the face, among other areas.

Lymphedema is primarily caused by the obstruction of lymphatic fluid flow in certain parts of the body, leading to an abnormal accumulation of fluid in the interstitial tissues, resulting in localized tissue swelling. Due to the deposition of lipids, fat hardening, and abnormal proliferation of subcutaneous fibrous connective tissue, it can eventually lead to thickening, roughness, and toughening of the skin, hence it is also known as "elephantiasis." It is commonly found in the lower limbs, upper arms, genital area, and face.

Based on the etiology of lymphedema, it can be categorized into primary and secondary types.

Primary Lymphedema

This refers to lymphedema for which the cause is not clearly understood, often due to congenital malformation of the lymphatic system. Primary lymphedema can be further divided into hereditary lymphedema and sporadic lymphedema.

Hereditary: It has an incidence rate of approximately 10% and is further classified into Type I and Type II. If there is a family history, it is also known as Milroy's disease, which is a dominantly inherited condition.

Sporadic lymphedema has an incidence rate of about 90% and is divided into early-onset and late-onset types. Early-onset occurs before the age of 35, while late-onset occurs after the age of 35.

Secondary Lymphedema

This refers to lymphedema with a clear underlying cause, commonly associated with factors such as trauma, recurrent infections, postoperative conditions, and metastatic infiltration of tumors.

Congenital Diseases

Congenital lymphedema often arises from developmental abnormalities such as dilated lymphatic vessels, valvular insufficiency, or absence, leading to incomplete lymphatic system structure or blockage, resulting in the accumulation of lymphatic fluid rich in proteins and other substances in the interstitial spaces, ultimately causing lymphedema.

Acquired Injuries

This includes surgical procedures (lymph node dissection for cancer), parasitic infections (filariasis), trauma, radiation therapy, recurrent infections, and tumor infiltration and metastasis, all of which can lead to lymphatic vessel obstruction or damage, causing an increase in lymphatic fluid in the interstitial spaces.

Chinese Herbal Medicine

Research has shown that Chinese herbal medicines such as Huangqi Guizhi Wuwu Tang combined with Danggui Shaoyao San and Yixiao Xiaozhong Wan have certain functions in preventing and treating edema.

Acupuncture and Moxibustion

Acupuncture with plum blossom needles, moxibustion, and fire needling, combined with acupoint therapy in traditional Chinese medicine, have also been proven to promote blood circulation and lymphatic flow as adjunct therapies for lymphedema.

Mainly focus on skin care, closely observe the affected limb's skin for cracks, infections, and ulcers. In daily life, preventive measures such as using moisturizing lotion, wearing gloves, and timely disinfection should be adopted.

Diet

Adopt a healthy, balanced diet with low salt or high fiber foods, consume moderate amounts of easily digestible protein-rich foods to ensure adequate nutrition, consume plenty of fresh fruits and vegetables, drink plenty of water, and avoid smoking and alcohol.

Exercise

Engage in gradual limb exercises and participate in outdoor activities such as walking, practicing Tai Chi, and doing exercises to enhance the body's resistance, without causing excessive fatigue.

Lifestyle

Maintain a regular daily routine, engage in appropriate outdoor activities, protect the postoperative limb or affected limb's skin, avoid skin injuries or infections, and when engaging in activities that may cause injury, wear gloves to protect the hands. Be cautious of insect bites.

Emotional and Psychological Well-being

As lymphedema can lead to changes in the appearance of the limbs, resulting in a blow to self-image and self-esteem, family members should provide care and encouragement to the patient, and avoid discrimination, defamation, or neglect. Patients themselves should maintain a calm mindset, learn to regulate and relax emotions, pay attention to rest, and balance work and rest.

Avoid prolonged hanging or compression of the affected limb, such as tight jewelry like rings and watches, as these can cause poor blood circulation, leading to edema in the affected limb.

Prevent skin damage, dryness, and insect bites on the affected upper limb. If these conditions occur accidentally, immediately treat the wound with disinfectant and avoid scratching with hands to prevent infection from spreading.

Try to avoid wearing tight, synthetic underwear. Choose soft, loose, all-cotton materials to reduce irritation to the postoperative skin.

Avoid intravenous infusion, blood pressure measurement, and blood transfusions on the affected limb.

Avoid accidental strain, such as using a single hand on the affected side to hold onto the bus handrail. To prevent strain from sudden stops, it's best to avoid using the affected limb.

When sleeping, avoid placing prolonged pressure on the affected limb, adopt a lateral position with the healthy side, and when lying on the back, place a fixed pad under the affected shoulder joint to elevate the affected limb, which is conducive to improving lymphatic and venous return.