More About Wounds and Lymphedema

When a patient has venous insufficiency, the veins in their arms and legs aren’t adequately clearing these extremities and fluids accumulate. This leads to swelling and pain, along with the potential for poor wound healing. This can also be caused by lymphedema. We described the causes and signs of lymphedema in July’s first blog. In this second blog, let’s get into how Dr. Stevens helps treat patients with lymphedema who are having problems with wound healing. 

What are the stages of lymphedema? 

There are four stages to this condition: 

•     Stage 0 — Also called latent lymphedema, there are no visible changes, but the lymph transport is impaired. Patients may have tightness in the skin or heaviness.
•     Stage 1 — This is mild lymphedema. It includes mild swelling that will begin in the furthest part of the limb, such as the hand or foot, and slowly moves up the limb. Gravity causes this pooling during the day, and it may disappear at night when the limbs are raised.
•     Stage 2 — Moderate lymphedema causes the skin to acquire a spongy appearance and it pits less than in Stage 1 because the skin is gradually thickening due to fibrosis. Fatty tissue will likely be accumulating below the skin due to inflammation from the lymph fluid building in the tissues.
•     Stage 3 — Also known as severe lymphedema, the skin becomes very hard and scaly and enlarges significantly. The skin can begin leaking, a condition known as lymphorrhea through breaks in the skin. Skin folds become a problem and infections develop in them. The limbs become very heavy and impact movement.

Wound care in patients with lymphedema 

When a patient’s vascular or lymphatic function are impaired, any injury to the skin can lead to infection and incomplete healing of the wound. This is a dangerous situation and needs attention from a specialist such as Dr. Stevens. 

If a patient with lymphedema incurs a wound, these are some of the treatment steps used by Dr. Stevens to help heal the injury: 

•     Aggressive administration of antibiotics to avoid cellulitis
•     Debridement to remove necrotic tissue
•     Gentle scrubbing and irrigation of the wound
•     Compressive and non-adhesive dressings to help with wound healing and to avoid deep venous thrombosis
•     Massage therapy to help with fluid drainage
•     Exercise involving gentle muscle contraction
•     Applying either radiofrequency ablation or sclerotherapy to address the underlying venous insufficiency and venous hypertension
•     Application of Apligraf as needed to help with venous ulcer healing
•     Utilization of both CircAid and Flexitouch systems to help manage swelling

If you have swelling in your arms or legs, it can be a sign of venous insufficiency or lymphedema. Either way, Dr. Stevens should see you to get the situation under control. Call us at Premier Heart & Vein Care, (805) 540-3333, to set up your appointment.