Lymphedema: Responding to Our Patients' Needs

Lymphedema is greatly misunderstood in every possible circle—from healthcare providers to patients at risk. Lymphedema is a collection of excess water, interstitial fluid, plasma proteins, bacteria, and cellular waste products in the interstitial tissues as a result of an impaired lymphatic system (Cheville, McGarvey, Petrek, Russo, Taylor, et al., 2003; International Society of Lymphology [ISL], 2003). Ninety percent of interstitial fluid is removed by the circulatory system with the remaining 10% managed by the lymphatic vessels (Ridner, 2002). The lymphatic system is extensive throughout each of us. It begins as a fine network just under the skin surface and converges to become larger vessels deeper in the tissue. Fluid from the lower extremities moves up through the thoracic duct, running up the abdomen, and is affected by diaphragmatic pressures. Lymphatic fluid moves up through the nodal beds and dumps into the vascular system at the entrance of the superior vena cava.