Risk Reduction Practices
Pre-Surgical Risk Reduction
Patients scheduled for surgeries that will include lymph node removal and/or radiation therapy should be made aware of the risk of developing secondary lymphedema. In addition, measurements should be taken of both limbs (affected and unaffected) prior to surgery to get a baseline measurement for future reference.
Post-Surgical Risk Reduction
Patients who have had lymph nodes removed, with or without radiation, should be aware of the following strategies to reduce their risk:
Healthy Lifestyle - Maintaining healthy weight and exercising significantly lowers the risk of developing lymphedema. Exercise should be tailored to the individual’s preferences and abilities by a specialty provider, trained in lymphedema management. During exercise and activity, monitor the at-risk areas for any changes in size, shape, or sensations that differ from the rest of your body. Any exercise or activity should gradually build up an individual’s tolerance over time and not be straining. This approach helps to protect the lymphatic system while getting it in shape to tolerate more activity.
Skin Care - Keeping the skin clean and free from irritation can reduce the risk for lymphedema. Moisturizing dry skin reduces chafing cracks that may cause irritation. Protecting the skin with sunscreen and insect repellent also helps to reduce the risk for irritation and inflammation.
Medical Check-Ups - The National Lymphedema Network provides a resource guide to find certified, trained specialists in lymphedema management. Seeing a specialist for screening can help to reduce the risk for developing lymphedema. A lymphedema care provider can help to develop strategies for risk reduction and serve as an ongoing source of information and support for follow up.
Knowledge and Awareness - Common triggers that may cause swelling include:
Trauma or injury to the limb - Any injury to the limb can cause inflammation and risk overloading the already compromised lymphatic system.
Limb Constriction - Tight clothing or constriction can obstruct the normal flow of blood and lymph and may overload the lymphatic system. Some patients will wear a bracelet on the affected arm or leg to alert medical personnel to avoid venipuncture or blood pressure.
Extreme Temperatures - Prolonged exposure to heat can inflame the tissue and lead to swelling. Burns can also increase risk due to the inflammation and swelling that can occur.
Prolonged Inactivity - Gravity can make it difficult for the lymphatic fluid to move out of the limbs. Movement encourages muscle contraction and facilitates improved lymphatic function.
It is important to be aware of the signs and symptoms associated with inflammation and infection in the tissue. Any rash, redness, pain, or increased skin temperature can be a sign of infection. These symptoms warrant follow up with your health care provider. More information can be found in the section “Infection and Other Complications of Lymphedema.”
Self-Care Strategies - Evidence-based clinical research shows that a routine of self-manual lymphatic drainage gently stimulates the lymphatic vessels and many reduce the risk of developing lymphedema. Recommendations for self-care should be made on an individualized basis.
The National Lymphedema Network has more information in the Position Papers, written by research experts.