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Lymphoedema

Checked: 23-02-2023 by Vicky Ryan Next Review: 23-02-2024

Overview

Lymphoedema is a condition which occurs when there is damage to the lymphatic draining system. This causes a build-up of fluid and swelling of limbs, or other areas of the body.

Sirona care & health provides the Lymphoedema Service across BNSSG. They provide specialist care, treatment, support and advice to patients and their carers via a team of expert nurses. Clinics are held at Portishead and Cossham Hospital in Kingswood. Home visits can also be arranged if required - see referral form.

The Lymphoedema Service provides patient-centered care, undertaking holistic assessments, addressing physical and psychosocial health needs and individually planning and providing specialist treatments for patients with Lymphoedema.

The Lymphoedema Support Network website is a useful resource for patients and professionals.-

Who to refer

Adults with Primary Lymphoedema

Adults with Secondary Lymphoedema due to a variety of causes including: Cancer, Surgery, radiotherapy, infection, trauma, obesity, reduced mobility.

It is a requirement that skin is dry and intact.

Patients with a BMI >40 who have no other causes for their lymphoedema will be offered a course of three appointments where they will be assessed, measured for and fitted with appropriate compression hosiery. They will also be taught self-management techniques including skin care regimes and appropriate exercises.This is in line with the BLS ‘Treatment Pathway for Lymphoedema Patients with a Body Mass Index (BMI) equal or greater than 40 kg/m²’ See here for information.

They will then be discharged back to the care of their practice with the recommendation that they lose weight. They will be given a copy of any hosiery prescriptions/measurement sheets so new garments can be prescribed by the practice.

GPs can refer back to the service if they have concerns, e.g change in limb size impacting on compression garments.

Before referral

Guidance for GPs for patients who are being referred to the Lymphoedema service

Please print and give to your patient the Initial advice for your patient whilst awaiting referral document.

Services

Refer using the referral proforma via email to: sirona.lymphoedemateam@nhs.net

Contact details:

Marina Healthcare Centre, Second Floor, 2 Haven View, Portishead, North Somerset BS20 7QA

Tel: 01275 547573

Email: sirona.lymphoedemateam@nhs.net

Opening hours: Monday to Friday, 8.00am - 4pm

Resources

For information for doctors and healthcare professionals see:

https://www.lymphoedema.org/

The following document produced by the British Lymphology Society and Lymphoedema Support Network provides guidance on the management of cellulitis for patients with lymphoedema:

management_cellulitis.pdf (lymphoedema.org)

For self-care following assessment by the Lymphoedema Service, please see the following document:

GP Advice Supporting long-term self-management following assessment by Lymphoedema Service

Lipoedema

Diagnosis - Lipoedema UK - contains advice on recognising and referring for lipoedema.
UK Best Practice Guidelines - Lipoedema UK

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.