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]
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