Lymphoedema management during the COVID-19 pandemic

Abstract

Medical care for patients with oedema in the Polish health care system is fragmented and rarely ensures
continuity of therapy. During the COVID-19 pandemic, the availability of traditional forms is even more
difficult, which forces the search for alternative, remote forms enabling early diagnosis and implementation
of proper management. Thus article presents a model of management in patients at risk of developing
edema and with advanced disease in the pandemic days in the light of the current recommendations. In
the lymphedema clinic, a method of questionnaire preliminary qualification of patients reported by phone
or e–mail which facilitates distinguishing urgent cases (swelling that is advanced, rapidly increasing, especially
despite compression therapy, complicated by skin damage, occurring in children < 12 years old
or associated with advanced cancer) was introduced.

Between June 2020 and March 2021, 160 patients usually needing the adjustment of another compression
garment continued the therapy, and 94 persons required complex decongestive therapy and then prescribing
of compression product to be worn during a day were admitted for the first time. A narrative review of the
literature between 2011–2021 including prophylactic recommendations and conservative management
of edema in terms of its realistic applicability under the existing restrictions, was carried out. Despite the
limitations in the implementation of physiotherapy, the availability of therapy based on education and
compression therapy in connection with individually selected, aerobic exercise was maintained in the clinic.