Lymphedema and Lymphovenous Bypass: Perioperative Nursing Implications

Abstract

Lymphedema—the accumulation of fluid in tissues, usually in the upper and lower extremities—often results from lymph node dissection or radiation and can cause painful and debilitating swelling that may interfere with a patient's daily living activities and quality of life. The goal of treatment for lymphedema is to reduce the volume of fluid in the affected area. Lymphedema is staged according to presenting characteristics, and interventions may be surgical or nonsurgical, such as complex decongestive therapy. Lymphovenous bypass is a surgical procedure performed for the management of lymphedema and involves rerouting microvascular channels to allow for the drainage of fluid that has accumulated in the lymphatic tissue of the upper or lower extremities. It requires supermicrosurgery techniques because of the small size of the vessels being anastomosed. Perioperative nursing implications for lymphovenous bypass include OR preparation and providing emotional support for patients living with lymphedema.

Clinical Issues—January 2022

“…Indocyanine green is one of the most frequently used fluorescent agents and is favored it for its high safety profile, low allergenicity, and short half‐life, which allows repeat use during many procedures 2 . As a versatile fluorophore that resides on the near‐infrared end of the wavelength spectrum, indocyanine green has many applications, including sentinel lymph node mapping, 2,7 microsurgery for chronic lymphedema, 7,8 and angiography during breast reconstruction. For angiography, indocyanine green allows real‐time assessment of tissue viability, which is critical in procedures where the goal is to maintain adequate perfusion of the skin flap to prevent postoperative tissue necrosis after placement of a prosthesis or reconstruction using the patient’s own tissue 1,7 …”

Application of complete decongestive therapy after lymphaticovenular anastomosis of the lower limb combined with liposuction-A retrospective study research

“…Standardized CDT can relieve limb swelling and improve quality of life, particularly important for postoperative effect maintenance. [16][17][18] Therefore, the study retrospectively analyzed and evaluated the application of CDT in LVA of the lower limb combined with liposuction, aiming to provide reference and guidance for clinical treatment of lower extremity lymphedema.…”