Lymphedema Diagnosis and Treatment
Statements Addressing Common Risk Factors for Lymphedema
- Cancer-related therapy is a common risk factor for lymphedema.
- Infection is a common risk factor for lymphedema.
- Chronic venous insufficiency is a common risk factor for lymphedema.
- Surgery is a common risk factor for lymphedema.
Statements Addressing Diagnosis and Evaluation
- Clinical examination is sufficient for the diagnosis of lymphedema.
- Patients with lymphedema should have quantification of swelling.
- Radionuclide lymphoscintigraphy should be recommended for patients with suspected or diagnosed lymphedema.
- All patients with CVI (C3-C6) should be considered as lymphedema patients.
Statements Addressing Treatment
- Regular use of compression garments reduces progression of lymphedema.
- The choice of circular versus flat knit elastic compression is dependent upon the severity of lymphedema and limb shape.
- Adjustable (Velcro) devices should be the first treatment for lymphedema patients.
- Sequential pneumatic compression (SPC) should be recommended for lymphedema patients.
- Sequential pneumatic compression should be used for treatment of early stages of lymphedema.
- Manual lymphatic Drainage (MLD) should be a mandatory component of the management of patients with lymphedema.
- Manual Lymphatic Drainage should be used in the early stages of lymphedema.
- Surgery should be considered for patients with failed conservative treatment in higher than the second ISL stage.
Recommendation Grading
Overview
Title
Lymphedema Diagnosis and Treatment
Authoring Organizations
American Vein & Lymphatic Society
American Venous Forum
Society for Vascular Medicine
Publication Month/Year
March 7, 2022
Last Updated Month/Year
August 13, 2024
Supplemental Implementation Tools
Document Type
Consensus
Country of Publication
US
Document Objectives
Lymphedema imposes a significant economic and social burden in modern societies. Controversies about its risk factors, diagnosis, and treatment permeate the literature. The goal of this study was to assess experts’ opinions on the available literature on lymphedema while following the Delphi methodology.
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory, Hospital, Outpatient, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Diagnosis, Assessment and screening, Treatment, Management
Diseases/Conditions (MeSH)
D008209 - Lymphedema
Keywords
Lymphedema
Source Citation
Lurie F, Malgor RD, Carman T, et al. The American Venous Forum, American Vein and Lymphatic Society and the Society for Vascular Medicine expert opinion consensus on lymphedema diagnosis and treatment. Phlebology. March 2022. doi:10.1177/02683555211053532