• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Course Login

WoundEducators.com | Online Wound Care Certification Courses

Your online source for wound care certification.

  • Courses
  • About Us
    • Meet The Team
    • Risk-Free Guarantee
    • Accredited Wound Care Course Info
    • Student Testimonials
    • Our Mission to Help
  • Why Certify?
    • What’s Included
    • How Hard is Wound Care Certification?
    • Wound Care Certification Cost
    • Wound Care Certification for Nurses
    • Getting Started: Wound Care Certification
  • Resources
    • Sign up for Our Newsletter
    • Search Wound Care Jobs
    • Post a Wound Care Job
    • Submit Your Resume
    • I Completed My Wound Care Course – Now What?
    • Wound Care CE Hours Online
    • Wound Care Recertification Process
  • Certifications
    • Compare Wound Care Certification Options
    • ABWM® Wound Care Certifications
      • The CWCA® Certification
      • The CWS® Certification
      • The CWSP® Wound Care Certification
    • The WCC® Certification
    • The AWCC® Wound Care Certification
    • The CWCN® Certification
  • Blog
  • FAQ’s
  • Contact

How To Assess Lymphedema

June 25, 2017 Leave a Comment

1
SHARES
ShareTweetGoogle +Linkedin
PinterestRedditTumblrStumbleuponDiggDelicious

lymphedema assessment

Lymphedema can be defined as swelling of one or more limbs which may also include a portion of the corresponding trunk. Lymphedema can also affect the breast, head, neck or genitalia. It occurs when fluid and other components such as protein accumulate in the tissue spaces as a result of a disparity between the creation of interstitial fluid production and its transport or movement. It may be caused by damage to the lymphatic system (i.e., as a result of cancer treatment) or as the result of congenital malformation of the lymphatic system. It is a chronic condition with no cure, but it can be managed if diagnosed early on.

General Assessment of Lymphedema

Assessment of the patient with lymphedema should be structured and ongoing. The following information should be obtained:

  • extent, location and duration of the edema
  • presence of lymphadenopathy (swollen lymph nodes)
  •  involvement/quality of skin and underlying tissue
  • degree of shape distortion of the affected area
  • circumference and volume of the affected limb
  • presence of pitting (indicates excess interstitial fluid)- press firmly for 10 seconds with your finger or thumb for at least 10 seconds, being careful not to cause pain; if an indentation remains after you release pressure, pitting is present. The depth of any resulting indentation can be measured to assess the degree of pitting present.

Measuring Limb Volume

Limb volume measurement can be used to determine the extent and severity of lymphedema. It may also be used to assess whether treatment is effective or not. Limb volume should be assessed at the first visit, after two weeks of multilayer lymphedema bandaging and at follow-up.

When one limb is affected, both the affected and unaffected limbs are measured- the difference between the two is recorded as a percentage or in milliliters (ml). A diagnosis of lymphedema can be made if the volume of the swollen limb is 10% or more than that of the unaffected limb. When both limbs are affected, both are measured in order to track the progress of treatment. [Note: there is no effective way to measure edema affecting the head, genitalia, breast, neck or trunk. Obtaining digital photographs is recommended to record and monitor edema in these areas].

Water Plethysmography (Water Displacement Method)

The water displacement method is the gold standard for measuring limb volume and is the only reliable method available to assess edema of the hands and feet. This method follows the scientific principle that an object will displace its own volume of water. However, its use is limited by hygiene issues and ability to access this modality.

Circumferential Measurement

This is the most widely used method of calculating volume. It is reliable when a standard protocol is adhered to. Circumferential measurements of limbs can be entered into a computer program (such as a spreadsheet) designed to determine both individual and excess limb volume.

Perometry

This method uses ultraviolet light beams to measure the limb outline. Limb volume can be calculated from these measurements. The cost of the equipment limits its use, as does its inability to be used for the measurement of hand and foot volume measurements.

Bioimpedence

This method measures tissue resistance to an electrical current to measure fluid volume. A drawback to this method is that it is not very useful when bilateral swelling is present. Again, this technique is not widely used as the cost of the equipment can be prohibitive.

Limitations of Limb Volume Measurement

Measurement of limb volume is not particularly useful when both limbs are affected; however, measurements can be used to assess the effectiveness of treatment rendered. Also, limb volume measurements are less accurate in patients who have severe thickening of the outer skin layer (hyperkeratosis) or hardening of the skin with deep skin folds (elephantiasis).

Source:
Best practice for the management of lympoedema: International consensus (2006). http://ewma.org/fileadmin/user_upload/EWMA/Wound_Guidelines/Lymphoedema_Framework_Best_Practice_for_the_Management_of_Lymphoedema.pdf
Lymphedema (2013). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/healthprofessional/page1

Categories: Lymphedema, Wound Assessment and Documentation

About the Author

Laurie Swezey's avatar

Laurie Swezey, founder and president of WoundEducators.com, has been a Registered Nurse for more than a quarter century, with most of those years dedicated to wound treatment. Ms. Swezey is a Certified Wound Care Nurse and a Certified Wound Specialist.

Reader Interactions

Leave a Comment Cancel

This site uses Akismet to reduce spam. Learn how your comment data is processed.

sidebar

Blog Sidebar

Free Preview!

Sign up for our newsletter and enjoy a Free Preview of our Wound Care Certification Course!

Support Our “Where There’s a Wound, There’s a Way!™” Foundation

fundraiser logo

Join our “Where There’s a Wound, There’s a Way!™” fundraising campaign  Learn more

Payment Information

All major credit cards & PayPal accepted. All transactions are performed via a SSL secure server to ensure your privacy.

payments accepted visa mastercard amex discover paypal

Copyright © 2009-2021 WoundEducators.com
Wound Care Certification Courses | Risk Free Guarantee | Terms and Policies

We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept”, you consent to the use of ALL the cookies.
Cookie settingsACCEPT
Manage consent

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled
Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.
CookieDurationDescription
cookielawinfo-checbox-analytics11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checbox-functional11 monthsThe cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checbox-others11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-necessary11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-performance11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy11 monthsThe cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.
Functional
Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features.
Performance
Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.
Analytics
Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc.
Advertisement
Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. These cookies track visitors across websites and collect information to provide customized ads.
Others
Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet.
SAVE & ACCEPT