CBO-richtlijn 'Lymfoedeem'

- Lymphedema is a symptom of tissue fluid accumulation which arises as a consequence of impaired lymphatic drainage. This reduced drainage can be either congenital or acquired, for example after breast cancer treatment.

- Early diagnosis of a swollen limb and adequate treatment are important in order to prevent irreversible tissue changes.

- The medical history and characteristic clinical presentation form the cornerstone of the diagnostic process. Lymphoscintigraphy can be used to obtain additional information about the functioning of the lymphatic system.

- Information and recommendations on precautions, preventive measurements and self-management instructions are important to all patients with (risk of) lymphedema.

- Treatment for lymphedema has to be adjusted to the patient and may consist of several therapeutic options, including manual lymphatic drainage. After volume reduction has been accomplished, a well-fitted compressive garment is essential in the maintenance phase. Surgical procedures for lymphedema are strictly indicated and should be performed by protocol in a multidisciplinary setting with long-term follow-up.

- Lymphedema is seen in many medical disciplines. A treatment plan is drawn up on the basis of a thorough knowledge of the diagnostics and treatment, with targeted referral to paramedical personnel. As it is a chronic condition, lymphedema requires life-long treatment and follow-up. In view of the complex nature of lymphedema it is recommended that local lymphedema protocols be developed.