Sxs and Complications - Lymphedema Flashcards
onset of lymphedema
slow
progressive
pitting in early stages
edema is
not detectable clinically until interstitial volume reaches 30% above normal
stages of pitting
1+-4+
1+
barley detectable
tissue returns to normal almost immediately
2+
slight indentation is visible when skin is depressed
returns after 15-30 s
3+
deeper indentation
returns after 60-90s
4+
returns after 2-3 min
general sxs start
distally
general sxs
squaring of the toes
dorsum of foot
loss of ankle contour
asymmetric (if bilateral)
full sensation in the limb w/ tightness of the skin
rarely painful
skin changes
increase risk of infection
squaring of the toes
stemmers sign positive
dorsum of foot
buffalo hemp
rarely painful
c/o of discomfort and heaviness
skin changes
hyperkeratosis
papillomas
connective tissue changes
fibroblasts proliferate
collagen fibers
are produced
fatty tisse
increases
tissue changes
fibrotic changes and induration
stages
0-3
stage 0
latent stage
no visible/palpable edema
only subjective c/o’s
stage 1
reversible lymphedema
pitting edema
reduced with elevation (no fibrosis)
stage 2
spontaneously irreversible lymphedema
pitting becomes progressively more difficult
fibrosis sets in
stage 3
lymphostatis elephantiasis
non-pitting
significant skin changes
severe fibrosis/induration
significant skin changes –> 4
papillomas
hyperkeratosis
complications
progressive
no cure
increased risk of infection
increased risk of open wound
no cure –> complications
appropriate tx can contral sxs
increased risk of infection –> complications
cellulitis
bacterial
fungal
etc.
increased risk of open wounds –> complications
ability for body to heal wounds
possible complications
hyperkeratosis
fungal infections
lymph fistulas
lymph cysts
lymph varicosity
radiation fibrosis
hyperkeratosis
overabundant skin thickening
callus formation
wart like papillomas (toe creases)
fungal infections
itchy
grayish white film
moisture and maceration b/w the toes
peeling off of the skin
lymph fistulas
abnormal connections b/w the lymph vessels and the skin
lymph cysts
abnormally wide lymph vessels that cause tiny visible vesicles or blisters
that have the danger of rupturing and causing infection
lymph varicosity
superficial
dilated lymph vessels
radiation fibrosis
appears as a reddish-brown discoloration in the irradiated area