Edema Flashcards
reduction techniques for acute edema (9)
- bulky dressing
- high voltage pulsed current
- elevation
- cold packs
- retrograde massage
- compression
- elastic taping
- manual edema mobilization (MEM)
- exercise
acute edema - bulky dressing
applied at the time of surgery gives counterforce to the outflow (filtration) by changing the tissue pressure; composed of appropriate wound care dressing, fluffy gauze sponges, and rolled-on gauze
acute edema - high voltage pulsed current
reported to retard the high capillary permeability in very acute edema and frequently used as a modality to reduce acute edema
acute edema - elevation
hand above the heart (unless contraindicated) reduces outflow because it reduces the arterial hydrostatic pressure; ideally in a +45 degree “ski hill” position
acute edema - cold packs
cause vasoconstriction and thus reduce the outflow of fluid in the acute stage (unless contraindicated)
used in first 24-48 hours only as directed by physician
acute edema - retrograde massage
light retrograde massage with elevation facilitates diffusion of small molecules into the venous system
acute edema - compression
light compression (elastic glove, Coban, or low-stretch finger bandage wraps) facilitates small molecule absorption by the venous system and absorption of large and small molecules by the lymphatic system
acute edema - elastic taping
kinesio tape; when applied in a specific manner it is theorized that the edema reduces because patient movement pulls the skin in the opposite direction from where the tape was applied which puts a stretch on the initial lymphatic structures facilitating congested lymphatic absorption
acute edema - manual edema mobilization
designed to activate lymphatic vessels; following the first week of surgery, acute edema is transudate that is changing to exudate edema as the plasma proteins invade and are contained and only the lymphatic vessels can remove excess proteins from the interstitium
acute edema - exercise
proximal active motion of an extremity or gliding of the involved structures, or both, during the acute stage of wound healing decongests the lymphatic vessels and removes tissue waste products, resulting in better oxygenation to tissue and faster wound healing
reduction techniques for subacute edema (9)
- exercise
- MEM
- elastic taping
- myofascial release (MFR)
- thermal modalities
- loose compression
- pneumatic pump
- low stretch bandages, gloves, massage, chip bags
- contrast baths
reduction techniques for chronic edema
- all techniques for subacute edema
2. methods to soften indurated tissue
subacute edema - contrast baths
Commonly is performed by having the client immerse the hand in warm water for 3 minutes and then in cold water for 1 minute. This sequence is repeated four times, ending on cold.
cold 71.6 deg warm 98.6 deg
subacute edema - thermal modalities
heat will increase tissue elasticity and lymph flow and soften tissue due to decongestion of the lymph
fluidotherapy machine at 98 degrees
subacute edema - pneumatic pump
system mimics MLD by first decongesting trunk edema and then proceeding to the extremity(ies) with the sequence, a rolling light chamber pressure, and the timing used with MLD
subacute edema - elastic taping
kinesio tape; when applied in a specific manner it is theorized that the edema reduces because patient movement pulls the skin in the opposite direction from where the tape was applied which puts a stretch on the initial lymphatic structures facilitating congested lymphatic absorption
subacute edema - exercise
start proximally with diaphragmatic breathing, trunk stretches, trunk exercises, easy (appropriate) yoga trunk stretches
subacute edema - low-stretch bandages, gloves, massage, and chip bags
must be light to avoid collapsing the single-celled initial lymphatics in the dermal layer
subacute edema - myofascial release
MFR
manual technique that entails sustaining a very light gentle pressure on soft tissue that in turn impacts the fascial system directly below the therapist’s hands resulting in elongation or softening of the fascia and its ground substances
subacute edema - MEM
designed to activate lymphatic vessels; following the first week of surgery, acute edema is transudate that is changing to exudate edema as the plasma proteins invade and are contained and only the lymphatic vessels can remove excess proteins from the interstitium
chronic edema - methods to soften indurated tissue
chip bags, convoluted foam in stockinette, elastomer and elastomer-type products, silicone gel sheets, foam-lined orthoses, low stretch bandages, cotton finger wraps, loose stockinette and/or gloves
contraindications for MEM (8)
- infection is present
- over areas of inflammation
- presence of hematoma or blood clot in area
- presence of active cancer
- client has CHF, severe cardiac problems, or pulmonary problems
- during inflammatory (acute) stage of acute wound healing
- client has renal failure or severe kidney disease
- client has primary lymphedema or lymphedema arising from a mastectomy
