Compression in young people living with lymphoedema

Childhood lymphoedema is a complex condition that can present in many ways and may lead to significant physical and psychosocial complications. The initial diagnostic journey often encounters misdiagnoses, referral to numerous inappropriate services, and delays in a referral to lymphoedema specialists. And there is often poor understanding and communication among teachers, leading to negative encounters at school. All of this can leave children and their parents frustrated and confused.

Dale (1985) examined the incidence of primary lymphoedema and estimated a frequency of 1 in 6000, with a sex ratio of approximately one male to three females. Childhood lymphoedema, however, is very rare. Smeltzer and colleagues (1985) calculated the annual incidence rate in children and young people under 20 years of age to be 1.15/100 000 population, but this is likely to be an underestimate.

Management of lymphoedema is lifelong and is focused around reducing and re-routing the swelling by applying compression and carrying out lymphatic massage, maintaining healthy skin and preventing cellulitis, encouraging the natural lymphatic flow through exercise, and maintaining a healthy weight. Compression is the linchpin of management in lymphoedema and is delivered using a variety of methods including hosiery, bandaging, and adjustable wraps.