Specialist Lymphoedema Services
The Lymphoedema Service is committed to providing specialist care to patients who have developed lymphoedema or any other chronic oedema.
What is lymphoedema?
Lymphoedema is the result of accumulation of fluid and other elements (e.g. protein) in the tissue spaces due to an imbalance between interstitial fluid production and transport (usually low output failure). It arises from congenital malformation of the lymphatic system or damage to lymphatic vessels and/or lymph nodes. Lymphoedema may manifest as swelling of one or more limbs and may include the corresponding quadrant of the trunk. Swelling may also affect other areas such as head and neck, breast or genitalia.
Lymphoedema specialist services
The service recognises the need to create an environment where the patient can feel secure, valued and be able to talk openly about their condition and any worries or concerns they may have.
It is believed that by empowering patients with all the appropriate knowledge and understanding of their condition, they will be able to manage their condition competently, confidently and with independence.
The service aims to:
- Offer specialist support, advice and management of complex symptoms for patients with primary and secondary or mixed oedemas
- Enhance the quality of life for patients and carers
- Recognise the right of the individual and their family to information about their disease and treatment in order that they can make informed decisions
- Provide specialist advice and support to staff in order to facilitate appropriate care
- Evaluate the effectiveness of specialist interventions through audit outcomes
A number of therapies and treatments are available.
Decongestive Lymphatic Therapy (Intensive Treatment)
Intensive therapy reduces swelling by decongesting impaired lymphatic pathways, reducing lymphatic load, encouraging the development of collateral drainage routes and stimulating the function of remaining patient routes.
Intensive therapy regimes use a combination of skin care, multi-layer lymphoedema bandaging (MLLB), exercise/movement and elevation. It may include manual lymphatic drainage (MLD) and intermittent pneumatic compression (IPC). The frequency of treatment, the degree of compression and type of bandaging used should be adapted to patient’s physical and psychological needs. Appropriate training is required for all practitioners who deliver intensive therapy programmes.
Manual Lymphatic Drainage (MLD)
Manual lymphatic drainage is a gentle massage technique that is recognised as a key component of decongestive therapy. MLD aims to encourage fluid away from congested areas by increasing activity of normal lymphatic’s and bypassing ineffective or obliterated lymph vessels.
MLD is conducted by practitioners with training at a specialist level.
Simple Lymphatic Drainage (SLD)
Simple lymphatic drainage is a simplified self-administered version of MLD that patients and carers can learn and apply themselves.
SLD is conducted and taught by a practitioner with appropriate training.
Intermittent Pneumatic Compression (IPC)
IPC consists of an electrical air compression pump attached to an inflatable plastic garment that is placed over the affected limb. The garment is inflated and deflated cyclically for a set period of time. The pressure produced by the garment can be varied. Garments maybe single chambered or contain multiple chambers that are inflated sequentially to provide a peristaltic massaging effect along the length of the limb.
Kinesiotape is a specialised form of adhesive tape made up of 100% cotton. Kinesiotape has been designed to mimic the qualities of the skin. The tape has a direct effect on the superficial lymphatic vessels just beneath the skin, allowing the lymph fluid immediately underneath to drain more freely.
Laser therapy is used to soften tissue and allow better lymphatic drainage. The low-level laser therapy (LLLT) brings about a photochemical reaction at a cellular level. This invisible wave-length penetrates deeply into tissue
Walsall Lymphoedema Service supports two patient information groups:
Aims to provide support and advice to local people and their families suffering with lymphoedema
Meets three times per year at Palliative Care Centre 11am – 1pm
Membership is free.
Aims to provide useful /relevant information to women with lymphoedema as a consequence of a cancer diagnosis
Meets twice a year at the Palliative Care Centre 6.30pm – 8.30pm
Membership is free.
The service operates Monday to Friday. 9am – 5pm. An answering machine facility is available for out of hours enquiries.
Palliative Care Centre
Louise Rooney, Lead Nurse
Referrals to the service are accepted from patients and carers. Written referals are required from any agencies or healthcare professional involved in the patients care. Where referrals are not from a health professional, clarification regarding diagnosis/medical condition will be sought prior to a referral acceptance.
It is the aim of the Lymphoedema Service to process all referrals within 24 hours of receiving them within normal working hours. All referrals are individually assessed by the lead nurse and appointments allocated accordingly.
All patients with a palliative diagnosis will be seen within seven working days of receipt of referral.
The Lymphoedema Service will assess, advise and implement appropriate care to any patient who has been referred to the service and who has oedema affecting any part of their body.
- The Lymphoedema Service will assess patients with a cancer or non-cancer diagnosis.
- The service will only assess patients aged 18 years or older.
- The service only accepts referrals for patients who are either registered to a Walsall general practitioner and/or reside within the Walsall Borough.
- Walsall Lymphoedema Service will assess patients within any community setting and offer specialist advice and support to the acute sector.
- The service will assess, advise and implement appropriate care to patients receiving care at St Giles Hospice, Walsall.
Non-acceptance of referrals
A referral may not be accepted or there may be a delayed response if:-
- The patient does not meet the referral criteria stated above
- The patients’ medical condition is contra-indicated for lymphoedema treatment and deemed unsafe or inappropriate
- Insufficient information is received regarding diagnosis
- The patient declines an assessment
If a patient does not meet the referral criteria it will be discussed on an individual basis with the referring agent and if appropriate the patient.
Patients will be discharged following:
- Failure to attend their clinic appointment and not notifying the clinic
- Failure to respond to written correspondence from the service to contact for future appointments within a two week period