Causes
Chronic oedema is oedema that has been present for 3 months or more. The main causes are:
- Chronic venous disease
- Prolonged dependency/immobility e.g. follwing stroke, failure to go to bed, wheelchair bound.
- Obesity
- IV drug abuse
- Medication side effects e.g. steroids, gabapentin, Amlodipine
- Significant trauma e.g. extensive burns, degloving etc
- Chronic organ failure e.g cardiac, renal, liver (not suitable for compression until medically assessed and condition is stable)
- Chronic inflammatory conditions e.g. arthritis, dermatological conditions
Further reading
Cooper G (2013) Compression therapy in chronic oedema and lymphoedema Nursing and Residential Care 15 3 134-9
Stigent A (2009) Tackling obesity as part of a lymphoedema management programme Chronic Oedema Suppl October S9-14.
Prevalence
Chronic oedema prevalence rates of 1.33:1000 have been cited in the literature but in reality these figures are thought to be much higher (Moffatt, Franks, Doherty et al, 2003). A recent report has shown this prevalence to be much greater (Cooper and Bagnall 2016). Prevalence is higher in women and in people age >65 the prevalence ncreases sharply with age. These sources can be viewed through the links below.
Chronic oedema can be managed in the community by addressing the factors influencing the swelling and compression therapy. Community nurses treating this group of patients must be cognizant with the theory and practice of compression bandaging.
More on management of chronic oedema and lymphoedema
Lymphoedema is a type of chronic oedema and therefore many of the same principles of management apply. However, patients with true lymphoedema should be assessed by a lymphoedema practitioner who will be skilled in providing the key components of care for this patient group, namely: lymphatic massage, skin care, exercise, and compression therapy. Patients might attend a specialist clinic for assessment, but then be referred back to the community team if specialist intervention is not required. Click here for a list of lymphoedema services in Scotland
Lymphoedema and chronic oedema can have many effects including cellulitis, body image and reduced function of the limb(s).
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