TABLE 3

Management of lymphedema diagnosed clinically or by lymphoscintigraphy

Refer to vascular medicine or surgery, plastic surgery, or both
Start conservative therapy

  • • Refer to physical therapy and consider manual lymph drainage

  • • Continuous compression garment use (circular vs flat knits)

Assess response to therapy at 6 months

  • • If symptoms are improved, continue conservative therapy, including compression garment use with annual prescription depending on patient compliance

  • • If symptoms do not change or if they worsen, consider referral to surgery for debulking or excisional or suction-assisted lipectomy in healthy patients at low surgical risk

  • Adapted from reference 26.