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What is Lymphedema?

The lymphatic system is a complex network of lymph vessels and nodes throughout the body.  It connects to the circulatory system and is responsible for the body’s ability to fight infections. Lymph vessels travel the same route as blood vessels. The system can become overloaded with lymph fluid due to excessive fluid, missing/removed lymph nodes/vessels, and lymphedema will develop.

Lymphedema can develop in any area of the body- arms, legs, breast, chest, face, head, neck, trunk, or genitals.

Types of Lymphedema

There are 2 types of lymphedema:

Primary Lymphedema
  • rare, inherited condition being born with impaired or without some lymph nodes or vessels
  • can be present from birth, develop prior to puberty, or even adulthood
Secondary Lymphedema
  • caused by another medical condition in which chronic swelling due to surgical lymph node removal, effects of radiation treatment, systemic conditions (ie. obesity, congestive heart failure, kidney disease, atrial fibrillation, chronic venous insufficiency), any type of surgery, an infection, or trauma to the body

Lymphedema Evaluation

A formal occupational therapy evaluation will be needed before treatment can begin.

WakeMed is currently the only hospital in North Carolina to include an advanced SOZO® screening as part of the evaluation.

SOZO can rapidly detect certain changes in the body before any symptoms occur, which can reduce the incidence of clinical lymphedema by almost 90 percent. This technology actually makes lymphedema prevention possible for some patients, and it can monitor the efficacy of treatment is patients who have already been diagnosed with it.


Lymphedema Treatment

There are 2 stages in the treatment of lymphedema.

Intensive Phase

Complete Decongestive Therapy (CDT) is begun.

1 – Skin inspection/care

  • Improving skin integrity identifying superficial openings/cracks and promote good hygiene to decrease risk of infections.

2 – Manual Lymphatic Drainage (MLD) techniques

  • A skin-stretching technique is used to clear the lymphatic system of stagnant lymph fluid.
  • Then, fluid stuck in the tissues is directed to new lymph pathways to encourage efficient flow and reduce swelling.

3 – Multilayer Compression Wrapping

  • Several layers consisting of soft padding and short-stretch bandages are used to get a proper compression gradient that will counteract venous pressure, increase pressure on tissues, provide support to skin to allow active muscles to encourage movement of lymphatic fluid through veins and lymph vessels.

4 – Exercises in Compression

  • With compression, specific exercises are taught that activate muscles and encourage skin to stretch under compression wraps.
  • This also helps veins and lymph vessels effectively pump fluid back into the body.

Maintenance Phase

  1. Patients and their caregivers are trained throughout the intensive phase on how to self-manage this chronic condition throughout their lifetime.
  2. Proper daytime and nighttime compression garments (or devices) are obtained by the patient. In some cases, a lymphedema pump is also needed.
  3. Patients continue to manage lymphedema on their own to prevent complications of this progressive condition.

Expertise Available at WakeMed

WakeMed Outpatient Rehabilitation therapists provide Complete Decongestive Therapy, the international gold standard treatment for lymphedema.  They are trained in the Dr. Vodder method of Manual Lymphatic Drainage.  Please contact one of the following WakeMed Outpatient Rehab locations where lymphedema evaluation and treatment are available.

WakeMed Outpatient Rehab

3701 Wake Forest Road, Suite 120, Raleigh


WakeMed Outpatient Rehab

(inside WakeMed North Hospital)

10000 Falls of Neuse Road, Raleigh

WakeMed Outpatient Specialty Rehab

(inside WakeMed Cary Hospital)

1900 Kildaire Farm Road, Cary

OT/Lymphedema Referrals:

For lymphedema referrals, medical staff may fax an order to 919-350-8959.

Patients may call 919-350-7000 to schedule an evaluation.

Learn more about SOZO and lymphedema screenings at WakeMed.