Lymphoedema Service

The CGH Lymphoedema Service provides screening, diagnosis, and treatment of lymphoedema through structured evidence-based protocols, aimed at improving care and enhancing outcomes for patients with limb swelling related to abnormalities in the lymphatic system. The service focuses on early detection, proactive management, and personalised care to minimise disease progression and empower patients in managing their condition effectively by partnering them in their treatment journey.

The CGH Lymphoedema Service adopts a holistic approach supported by a multi-disciplinary care team comprising surgeons, occupational therapists, physiotherapists, and specialist nurses trained in the management of lymphoedema. Throughout the patient's journey, the team collaborates to develop tailored care plans that align with patients’ needs, lifestyles, and goals.

Patients identified to be at risk of developing lymphoedema are referred to the service’s structured screening programme that includes Indocyanine Green Lymphography (ICGL), an imaging technology that facilitates early detection of the condition by highlighting lymphatic dysfunction. Regular surveillance through ICGL also allows the care team to track patients’ condition and progress over time and make proactive adjustments to care plans accordingly.

Indocyanine Green Lymphography (ICGL)

Left: Linear channels showing normal lymphatic flow in a foot.
Right: Patterns resembling white splashes show dermal backflow in the skin, indicating lymphoedema.

By offering early intervention, the CGH Lymphoedema Service supports patients in preventing disease progression and enhancing treatment outcomes, while minimising the need for invasive procedures.

Specialist nurses provide comprehensive perioperative care, facilitate referrals for screening and diagnosis, and offer education, compliance support, and wound management. Therapists complement this with combined decongestive therapy, manual lymphatic drainage, compression therapy, and tailored exercises, promoting effective symptom management. Patients are guided in setting realistic goals that balance their treatment requirements with daily activities, such as work and social commitments. This patient-centered approach ensures better adherence to care plans, leading to improved outcomes and quality of life.

The CGH Lymphoedema Service provides the following services:

Prospective screening and diagnosis of lymphoedema via indocyanine green lymphography (ICGL)
Conservative Treatments:
- Combined decongestive therapy
- Manual lymphatic drainage
- Compression therapy
- Tailored exercise programmes
- Lymphoedema education
Surgical Interventions:
- Physiological lymphoedema surgery such as supermicrosurgical lymphovenous anastomosis (lymphatic bypass), vascularised lymph node transfer, lymph vessel transfer, and Lymph Interpositional Flap Transfer (LIFT)
- Primary and secondary surgical prevention through lymphatic reconstruction
Surveillance of lymphoedema condition through a structured protocol