Wound Care Today - page 16

16 WOUND CARE TODAY 2015,Vol 2, No 1
FOCUS ON OEDEMA i
Chronic oedema is a term
used for swelling that has
been present for at least
three months in a limb or limbs
and/or mid-line structures, such as
the trunk, head, neck or genitalia
(Moffatt et al, 2003).
Chronic oedema of the
lower limb is not always dealt
with promptly or effectively,
which can be due to lack of
knowledge and inexperience
in clinicians, or delay in
patient contact (Morgan et
al, 2005). Chronic oedema
can result in leg ulceration,
delayed healing and can
greatly reduce patient quality
of life as a result of increased
exudate, pain, immobility,
difficulty with clothing and footwear,
social isolation, and the susceptibility
to wound infections and cellulitis
(Williams, 2003).
The causes of oedema and managing
any associated complications
If not recognised and treated
properly, oedema will steadily
worsen and symptoms will increase
in severity and become irreversible.
Unfortunately, the condition is
all-too-often misdiagnosed or
diagnosis and prompt early treatment
to reduce the impact that chronic
oedema has on patient quality of life,
both physically and psychosocially.
CIRCULATION AND LYMPHATICS
Clinicians need a clear
understanding of how the
lymphatic and venous systems
function, and how problems
can lead to the build up of
oedema. When the circulatory
and lymphatic systems are
working correctly, blood passes
through the capillaries (a
process known as filtration)
and fluid leaks out through
the semi-permeable walls and
into the interstitial space that
lies between the capillary wall
and the tissues. This fluid is known
as interstitial fluid. The movement of
nutrients, waste, fluid, electrolytes,
and proteins between the vascular
and lymphatic systems and tissue
cells occurs in the interstitial fluid.
Normally, the amount of fluid passing
Jeanette Milne, tissue viability nurse specialist,
South Tyneside Foundation Trust
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Figure 1. Patient with oedema at the ankle.
Top tip:
When oedema has been present
for at least three months, it is
considered to be chronic.
undiagnosed, which in turn leads to
ineffective and costly treatments. It
is essential that a correct diagnosis
is established before treatment is
initiated. If the signs and symptoms
of oedema are spotted early,
treatment of the underlying cause can
be started, so that disease progression
can be halted or slowed.
Better understanding of the
different causes of oedema helps
clinicians provide effective treatment.
This article will highlight the causes
and presenting features that aid
Credit: John Campbell @flickr.com