open access

Vol 15, No 3 (2021)
Research paper
Published online: 2021-07-03
Get Citation

Lymphoedema management during the COVID-19 pandemic

Katarzyna Ochałek12, Joanna Kurpiewska3, Tomasz Grądalski2
DOI: 10.5603/PMPI.2021.0021
·
Palliat Med Pract 2021;15(3):225-232.
Affiliations
  1. Instytut Rehabilitacji Klinicznej, Akademia Wychowania Fizycznego w Krakowie
  2. St. Lazarus Hospice, Fatimska 17, 31-831 Krakow, Poland
  3. Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego

open access

Vol 15, No 3 (2021)
Research paper
Published online: 2021-07-03

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.

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.

Get Citation

Keywords

lymphedema, edema, lymphatic therapy, COVID-19

About this article
Title

Lymphoedema management during the COVID-19 pandemic

Journal

Palliative Medicine in Practice

Issue

Vol 15, No 3 (2021)

Article type

Research paper

Pages

225-232

Published online

2021-07-03

Page views

6438

Article views/downloads

455

DOI

10.5603/PMPI.2021.0021

Bibliographic record

Palliat Med Pract 2021;15(3):225-232.

Keywords

lymphedema
edema
lymphatic therapy
COVID-19

Authors

Katarzyna Ochałek
Joanna Kurpiewska
Tomasz Grądalski

References (27)
  1. Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology. 2020; 53(1): 3–19.
  2. Gradalski T. Edema of Advanced Cancer: Prevalence, Etiology, and Conservative Management-A Single Hospice Cross-Sectional Study. J Pain Symptom Manage. 2019; 57(2): 311–318.
  3. Keast DH, Moffatt C, Janmohammad A. Lymphedema Impact and Prevalence International Study: The Canadian Data. Lymphat Res Biol. 2019; 17(2): 178–186.
  4. Grądalski T, Ochałek KW. stronę systemu opieki medycznej w zastoinowej niewydolności chłonnej – Głos w dyskusji. Acta Angiol. 2013; 19(1): 46–49.
  5. Giusti R, Ravoni G, Porzio G, et al. Rapid Transition to Virtual Care during the COVID-19 Epidemic: Experience of a Supportive Care Clinic at a Tertiary Care Cancer Center. J Palliat Med. 2021 [Epub ahead of print].
  6. Dzierżanowski T, Gradalski T, Kozlowski M. Palliative Performance Scale: cross cultural adaptation and psychometric validation for Polish hospice setting. BMC Palliat Care. 2020; 19(1): 52.
  7. Gradalski T, Ochalek K. Lay Caregivers Education in Multicomponent Compression Bandaging in Obese Patients with Lower Limb Edema: A Case-Control Pilot Study. Lymphat Res Biol. 2020; 18(5): 428–432.
  8. Davies C, Levenhagen K, Ryans K, et al. Interventions for Breast Cancer-Related Lymphedema: Clinical Practice Guideline From the Academy of Oncologic Physical Therapy of APTA. Phys Ther. 2020; 100(7): 1163–1179.
  9. Park JH, Merriman J, Brody A, et al. Limb Volume Changes and Activities of Daily Living: A Prospective Study. Lymphat Res Biol. 2021; 19(3): 261–268.
  10. Dylke ES, Schembri GP, Bailey DL, et al. Diagnosis of upper limb lymphedema: development of an evidence-based approach. Acta Oncol. 2016; 55(12): 1477–1483.
  11. Rafn BS, McNeely ML, Camp PG, et al. Self-Measured Arm Circumference in Women With Breast Cancer Is Reliable and Valid. Phys Ther. 2019; 99(2): 240–253.
  12. Koelmeyer LA, Borotkanics RJ, Alcorso J, et al. Early surveillance is associated with less incidence and severity of breast cancer-related lymphedema compared with a traditional referral model of care. Cancer. 2019; 125(6): 854–862.
  13. Liang M, Chen Q, Peng K, et al. Manual lymphatic drainage for lymphedema in patients after breast cancer surgery: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020; 99(49): e23192.
  14. Ochalek K, Partsch H, Gradalski T, et al. Do Compression Sleeves Reduce the Incidence of Arm Lymphedema and Improve Quality of Life? Two-Year Results from a Prospective Randomized Trial in Breast Cancer Survivors. Lymphat Res Biol. 2019; 17(1): 70–77.
  15. Sawan S, Mugnai R, Lopes Ad, et al. Lower-limb lymphedema and vulval cancer: feasibility of prophylactic compression garments and validation of leg volume measurement. Int J Gynecol Cancer. 2009; 19(9): 1649–1654.
  16. Shallwani SM, Towers A, Newman A, et al. Feasibility of a Pilot Randomized Controlled Trial Examining a Multidimensional Intervention in Women with Gynecological Cancer at Risk of Lymphedema. Curr Oncol. 2021; 28(1): 455–470.
  17. Baumann FT, Reike A, Hallek M, et al. Does Exercise Have a Preventive Effect on Secondary Lymphedema in Breast Cancer Patients Following Local Treatment? - A Systematic Review. Breast Care (Basel). 2018; 13(5): 380–385.
  18. Leray H, Malloizel-Delaunay J, Lusque A, et al. Body Mass Index as a Major Risk Factor for Severe Breast Cancer-Related Lymphedema. Lymphat Res Biol. 2020; 18(6): 510–516.
  19. Thompson B, Gaitatzis K, Janse de Jonge X, et al. Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature. J Cancer Surviv. 2021; 15(2): 244–258.
  20. Rabe E, Partsch H, Hafner J, et al. Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology. 2018; 33(3): 163–184.
  21. Gatt M, Willis S, Leuschner S. A meta-analysis of the effectiveness and safety of kinesiology taping in the management of cancer-related lymphoedema. Eur J Cancer Care (Engl). 2017; 26(5).
  22. McNeely ML, Campbell KL, Webster M, et al. Efficacy of night-time compression for breast cancer related lymphedema (LYNC): protocol for a multi-centre, randomized controlled efficacy trial. BMC Cancer. 2016; 16: 601.
  23. Brown A, Nicholson C, Fearing A, et al. Lymphoedema management by independent hospices: a cohort study. BMJ Support Palliat Care. 2019; 9(4): 389–396.
  24. Lee CH, Kim JK, Jun HJ, et al. Rehabilitation of Advanced Cancer Patients in Palliative Care Unit. Ann Rehabil Med. 2018; 42(1): 166–174.
  25. Towers A, Hodgson P, Shay C, et al. Care of palliative patients with cancer-related lymphoedema. J. Lymphoedema. 2010; 5(1): 72–80.
  26. Gradalski T. Obrzęk związany z zaawansowanymi schorzeniami – przyczyny, rozpoznanie i postępowanie lecznicze w opiece paliatywnej i hospicyjnej. . Palliative Med. Paliatywna Termedia. 2019; 11(1): 1–8.
  27. Landers A, Thomson M. Quantitative study of the subcutaneous needle drainage of lymphoedema in advanced malignancy. . J. Lymphoedema. 2017; 12(1): 22–26.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73 , 80–180 Gdańsk, Poland

phone:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl