Best practice for chronic oedema in community settings: what can we learn?

The creation of the latest guidance ‘Chronic oedema: best practice in the community’, builds on work that has been done in the past and presented in the original guidelines ‘Best practice for the management of lymphoedema’ and the ‘Compression therapy: a position document on compression bandaging’ (International Lymphoedema Framework (ILF), 2006; 2012). Equally, it complements other guidelines that have been created, for example, ‘S.T.R.I.D.E. professional guide to compression garment selection for the lower extremity’ by Bjork et al (2019) and others shown within Table 1. The best practice and/or statements bring together the best available evidence at that time, alongside clinical opinion. These form part of the principles that are present in the application of evidence-based practice and how this can improve the care of patients (Black, 2015; Brownie, 2018). It has been estimated that some 4 per 1000 individuals in England may be affected by chronic oedema, and this figure increases with age to up to 29 per 1000 individuals (Moffatt et al, 2017). Individuals with chronic oedema who are older, for example those older than 65 years, may also present with multiple long-term conditions, and be already receiving care from several services, both primary and secondary (Rankin, 2016; National Lymphoedema Partnership (NLP), 2019). This adds complexity to the care that those diagnosed with chronic oedema or lymphoedema may receive from health professionals. It also adds emphasis to the need to have access to guidance and best practice in managing these patients.