Lymphedema interventions: exercise, surgery, and compression devices.

OBJECTIVES: To review exercise, surgical treatment, and intermittent pneumatic compression in the risk reduction and treatment of lymphedema, and to provide applications of the evidence to the care of the oncology patient with or at risk for lymphedema. DATA SOURCES: Systematic reviews of the contemporary literature (2004-2010) examining exercise, surgical treatment, and intermittent pneumatic compression use in lymphedema therapy, peer-reviewed publications, and web sites of professional organizations.
CONCLUSION: Exercise and intermittent pneumatic compression are effective therapies and can be safely implemented in appropriate patients as an adjunct to complete decongestive therapy. Surgical treatments have proven beneficial in carefully selected patients, but require continued use of life-long compression therapy. Intermittent pneumatic compression devices are a safe adjunctive treatment option for in-home use in appropriate patients at low to moderate pressure ranges, following and in conjunction with complete decongestive therapy. IMPLICATIONS FOR NURSING PRACTICE: Informed oncology nurses can assist patients in an individualized, integrated multimodality approach to lymphedema therapy.