Lymphoedema/Chronic Oedema

Definitions of Lymphoedema

· Primary lymphoedema:-

Arises from an intrinsic defect in lymph pathways. Can present at birth, in early childhood or in adult life. May be inherited. The term is often used when there is no identifiable external cause.

· Secondary lymphoedema:-

Results from damage to the lymphatic system. This may be cancer-related (surgery/radiotherapy, or metastatic or advanced disease), or due to non cancer-related causes, such as trauma or infection.

· Chronic Oedema:-

A term applied to chronic swelling where the lymphatics are not damaged but have become overloaded due to a prolonged increase in interstitial fluid volume, for example, dependency/immobility swelling, venous disease, morbid obesity, and medication

· Lipoedema:-

A genetic condition that results in abnormal fat distribution in the legs and hips in females. Secondary oedema can develop as the fat cells can disrupt the microcirculation

Services

There are three lymphoedema services operating across NHS Lothian. Please see Lymphoedema Service Referral Pathway June 2020.png to determine which service to refer your patient to.

Who not to refer:

Those at risk of lymphoedema
Morbidly obese patients who are yet to request support in addressing their weight.
Those who are unlikely to respond to lymphoedema management and the primary cause of the swelling requires further investigation or treatment including those with, acute DVT, renal/cardiac/liver disease, hypoproteinaemia, Baker’s cyst.
Those with ABPI of <0.5 – Consider referral to Vascular

Lothian Primary Care Lymphoedema Service

Contact Details:-

Lothian Primary Care Lymphoedema Service – 0131 453 9362

Ben Blundell / Allan Thomson

lymphoedema@nhslothian.scot.nhs.uk

This service is Lothian-wide with 5 clinics across Lothian

Wester Hailes Healthy Living Centre (HUB CLINIC)
Leith Community Treatment Centre
Strathbrock Partnership Centre
Midlothian Community Hospital
East Lothian Community Hospital

How to refer:

SCI Gateway. We can be found under:

AHP – Physiotherapy
Lymphoedema Service
L Lymphoedema Service

Where SCI Gateway referral is not possible, please use the Referral Form.doc (either post to the address at the top of the form, or email to lymphoedema@nhslothian.scot.nhs.uk)

Referrals will be accepted from all Healthcare Professionals

We are happy to discuss any referrals in more detail

Edinburgh Cancer Centre Lymphoedema Service

Based in the Western General Hospital

Ellen Hardie / Anna J Carter

Only patients of the Edinburgh Cancer Centre are eligible for this service. They should have an Edinburgh Cancer Centre consultant and be living in the Edinburgh area. They should have lymphoedema related to their cancer.