Lymphoedema Resources

Compression is widely recognised as a vital component for healing venous leg ulcers (VLUs), for preventing them in at-risk patients and for long-term management to reduce recurrence. With current pressures on nurses to try to find resource and time saving solutions in patient care, management of complex wounds can prove challenging – compression bandaging is time and resource intensive and suitably competent staͿ often too few. As an alternative option, adjustable compression wraps can be an innovative solution in wound management and can successfully replace bandaging for patients with or without lymphoedema who have a VLU. This case report describes how the multidisciplinary team (MDT) approach to care for a patient with lymphoedema and bilateral leg ulcers achieved eͿective wound healing as well as reduction in swelling by using adjustable compression wraps, i.e. easywrap® strong. Successful team working between the treatment room, tissue viability nurse and patient resulted in patient empowerment, self-care and long-term support from the lymphoedema clinic.

Heart failure and lymphoedema are common conditions that often coexist, particularly in older people. Compression therapy, a cornerstone of lymphoedema care, is frequently withheld in those with heart failure due to safety concerns. This article explores the interaction between heart failure and lymphoedema, summarises current evidence on compression safety, and provides practical advice for community practitioners. It highlights key assessment tools (NYHA class, NT-proBNP, vascular tests), addresses common misconceptions, and signposts to national guidelines. With careful assessment and collaboration between cardiology and lymphoedema teams, compression therapy can be used safely in most patients, improving outcomes and quality of life.

Lymphoedema is a chronic, progressive condition caused by impaired lymphatic drainage, leading to swelling, skin changes and increased risk of infection. Although specialist services provide targeted treatment, many patients are first seen in community settings where generalist practitioners may have limited knowledge or training in lymphatic care. This article offers a practical overview to support non-specialist healthcare professionals in recognising and managing lymphoedema. It outlines prevalence, risk factors and common presentations, highlights key assessment and differential diagnosis points, and reviews core management principles, including compression therapy, skin care, exercise and patient education. The psychosocial impact of lymphoedema and the importance of timely referral to specialist services are also discussed. Early recognition, consistent advice and person-centred support can improve outcomes and quality of life, while collaborative working ensures safe longterm care.

As lymphoedema prevalence continues to rise causing increasing demand for services, optimising patient self-management is vital. In the UK, lymphoedema treatment models have traditionally followed the ‘four cornerstones’ approach, including skin care, compression therapy, physical activity, and lymphatic drainage massage. These address the physical manifestations of lymphoedema yet neglect the psychological and emotional impact. Since the establishment of the psychology service within the Lymphoedema Wales Clinical Network (LWCN) in 2023, a more holistic model of care has been introduced into clinical practice. This development reflects a growing recognition of the psychological burden associated with lymphoedema and the need for integrated support services. The introduction of the lymphoedema COMPASS treatment model represents a significant advancement in routine care delivery, combining physical and psychological interventions to support patients to live as well as possible with lymphoedema. The COMPASS model is designed to place individuals at the centre of their care, promoting active engagement and self-management. It supports and encourages patients to take ownership of their condition, including the emotional and psychological challenges that often accompany lymphoedema.

Lymphoedema is a progressive long-term condition that detrimentally affects many aspects of quality of life — physical, emotional, and social. The introduction of lymphoedema patient-reported outcome measures (PROMs) has supported patients to communicate the psychological impact, raising concerns such as anxiety, fear, low
mood, and poor body image. However, some healthcare professionals report feeling ill-equipped to respond effectively to these needs. This study explored lymphoedema healthcare professionals (LHCP) psychological and emotional education needs. A Google Forms survey was developed based on literature and expert opinion and disseminated via email to all staff (120) within Lymphoedema Wales Clinical Network (LWCN). Data demonstrated statistically significant correlations between levels of perceived  confidence, perceived skills to discuss psychological issues, and level of psychological training received (p <0.001). However, nearly three-quarters of participants reported never receiving psychological training. This study represents the first step in  understanding psychological education needs of LHCP and indicates future  opportunities to potentially improve clinical practice in this area.

Increasing pressures on healthcare resources require constant evaluation of the efficiency and effectiveness of provision, particularly for the rising number of vulnerable, elderly and obese patients. Practices regarding compression are arguably often ingrained due to its historical usage, with evidence from managing chronic venous insufficiency (CVI) underpinning its effectiveness. This evaluation explores the clinical benefit, impact, outcomes and cost-efficiencies of using an adjustable compression wrap system instead of previous care. ‘Before-after design’ observation of 50 patients captured baseline resource use, costs and outcomes (clinical and patient) at the time of assessment and again at a maximum of six-month follow-up. Data after using the adjustable compression wrap showed significantly improved clinician-reported outcomes: presence of wounds/leg ulceration (from 56% to 21%), incidence of cellulitis (halved), and reduced complexity/severity of lymphoedema. Additionally, patient- reported outcomes, visual analogue scale (VAS) health score and LYMPROM© scores for pain, heaviness, shopping for shoes and clothes, and body image significantly improved. The mean number of community nurse visits per patient reduced from 11.6. to 9.1, but was not statistically significant (p-value 0.09). However, this evaluation found that over six months there was a mean cost reduction of over £383.70 per patient, which included the purchase price of the adjustable compression wrap system.

Lymphoedema is a long-term condition which is incurable at the present time. Due to the nature of the condition, being both long-term and manifesting in physical changes (swelling), its impact on the person and their lives can be hard to quantify. Management options need to be considered within a person-centred approach, with the four cornerstones of treatment being skin care, exercise, compression therapy and manual lymphatic drainage (MLD). Evidence for each is varied and practitioners need to determine their therapeutic benefit. Beyond the cornerstones of treatment, future developments are ongoing within the areas of surgery, such as venous anastomosis and pharmacological interventions, which may reduce the effects of continual inflammation. In the future, these developments may become part of the care delivered to those affected by lymphoedema. However currently, skin care, exercise, and compression therapy remain fundamental, with MLD included if therapeutically indicated, as well as educating and empowering those involved in self-management with the support of practitioners.

The vast majority of wound care is undertaken by community nurses (Dhoonmoon, 2023), with £941 million attributed to venous leg ulcer care and a further £836 million spent on unspecified leg ulcer management (Guest et al, 2017). If signs and symptoms can be 
recognised and a diagnosis made, a plan of care can be drawn up and treatment implemented quickly and efficiently to reduce costs escalating further. More important though, the patient’s condition will improve quickly and deterioration in quality of life can be avoided. Nursing staff are currently encouraging patients to take a more active role in their own care, guiding them in how to look after their own long-term conditions, which can promote long lasting healing and independence.

Lymphoedema is a chronic, progressive condition, which can have a significant impact
on patients — both physically and psychologically. While there is no cure, it is vital that the condition is effectively managed to prevent deterioration and its impact on patient quality of life.

According to a best practice statement (Wounds UK, 2019), wound complexity increases the likelihood of wound chronicity and can make a wound hard to heal. A ‘complex’ venous leg ulcer (VLU) has a number of indications that link to lymphovenous disease