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Fife CE, Carter MJ, et al.
Ostomy/wound management. Date of publication 2008 Jan 1;volume 54(1):44-56.
1. Ostomy Wound Manage. 2008 Jan;54(1):44-56. Lymphedema in the morbidly obese patient: unique challenges in a unique population. Fife CE(1), Carter MJ. Author information: (1)Department of Anesthesiology, University of Texas Health Science Center, Houston, Texas, USA. Caroline.E.Fife@uth.tmc.edu The population of morbidly obese patients, along with the incidence of lymphedema and massive localized lymphedema associated with this condition, is increasing. A 5-year retrospective review of data (2000-2005) shows that the percentage of patients >350 lb in the authors' clinic population increased from approximately 7% to 11% and 75% of their morbidly obese patients (body mass index >40) had or have lymphedema. After a differential diagnosis between lipedema and lymphedema (primary or secondary) has been made, lymphedema management options include compression bandaging, manual lymphatic drainage, and localized surgeries. The treatment of morbidly obese lymphedema patients requires additional staff time and specialized equipment to move or position them and may be confounded by other conditions (eg, heart failure and venous insufficiency) that contribute to edema. Lymphedema treatments have been found to be useful, providing patients are able to follow treatment guidelines, especially with regard to weight control. In the authors' experience, massive localized lymphedema will recur unless the primary issue of obesity is addressed. Establishing clear criteria and patient participation guidelines before initiating a comprehensive localized lymphedema program will improve outcomes. PMID: 18250486 [Indexed for MEDLINE]
Appears in following Topics:
Lymphedema - Introduction and Assessment
Lymphedema - Treatment and Emerging Strategies for Prevention
Lymphedema - Treatment and Emerging Strategies for Prevention