Skin care considerations for those with chronic oedema or lymphoedema

Lymphoedema and chronic oedema are common conditions seen in community caseloads. Skin care is a frequent and crucial requirement in aiding the patient to feel comfortable, prevent infection, manage fluid excretions and assist with pain management. It is one of the cornerstones of care for those with lymphoedema/chronic oedema, in addition to compression therapy, exercise and manual lymphatic drainage. Crucially, the skin integrity needs to be maintained to the best possible extent to avoid breakdown of the skin. Community nurses play a vital role in skin care for those with lymphoedema/chronic oedema, and this article provides an up-to-date recap of the important things to remember when caring for the skin of someone who has chronic oedema or lymphedema.

The skin is a barrier to infection, and care of this barrier is, therefore, an integral part of lymphoedema and chronic oedema management. The British Lymphology Society (BLS) (2017) stated that infection can trigger lymphoedema, so preventing infection through good skin care is vital. The the skin should be washed daily with non-perfumed soap, kept well moisturised, protected from sunburn and treated for insect bites promptly using antihistamines (BLS, 2017). Correct footwear should be used to avoid abrasions, and regular checks should be conducted for skin folds and between toes for fungal infections. Cuts or scratches would need antiseptic treatment, and the GP should be contacted if the area is inflamed; where there are signs of cellulitis, this should be treated as quickly as possible (BLS, 2017). Without managing these areas, untreated skin tears and breaks can introduce infection and possible sepsis, with wounds that are extremely difficult to heal and require extensive community or hospital management on some occasions, potentially causing deterioration of the patient's physical and mental health, as well as costing the NHS a vast amount of money (BLS, 2017).