Infection prevention is an important part of lymphedema maintenance. Taking good care of your skin is a primary way to prevent infection. Lymphedematous tissue is prone to infection for a few reasons. Keep reading to find out why!
First, a limb with lymphedema is congested as a result of poor drainage (the lymphatic system in the affected limb is mechanically or structurally damaged and cannot handle the amount of lymph fluid it needs to, so fluid backs up). When lymph fluid stagnates, it causes immune deficiency. For example, transportation of immune cells (like lymphocytes and macrophages) to the lymphedematous limb slows down. Removal of bacteria and waste from the tissue slows down.
Think about a room in your house – let’s say your bathroom. What would happen if the sewer lines that drained your sink, shower or toilet water stopped working? Then imagine the cleaning crew and plumber were stuck in traffic, too. Do you have that picture in your mind? Now you have an idea of what happens when your lymphatic system isn’t working. The scene isn’t too pretty (or healthy).
Keep in mind, lymph nodes that drain fluid from the impacted limb become diseased. Removal of antigens (foreign substances like bacteria) is impaired. So, the skin of the lymphedematous limb becomes diseased itself (causing common presentational symptoms of lymphedema).1 One scratch, puncture or sunburn could be an entry point for bacteria.
Protein-rich fluid is food for the bad guys
Second, people with lymphedema are prone to infection because the involved limb contains protein-rich fluid. This fluid is a great place for bacteria to multiply. They have the food they need (feeding off the nutrients found in lymph fluid), and the immune cells that would stop them are delayed in getting to the scene because of the swelling. In math terms: Healthy bacterial growth + nothing to stop them = infection.
Third, as noted earlier, skin becomes diseased in lymphedema. One resulting symptom can be itching (pruritus). Minor trauma caused by itching can compromise skin integrity and be an entry point for bacteria. Another can be hyperkeratosis, one of the skin presentations that may occur as lymphedema progresses. Hyperkeratosis is a thickening of the skin skin due to overgrowth of keratin cells which causes elevations where bacteria can grow.
For tips on preventing infection and managing lymphedema, see December’s blog.2 Also visit the National Lymphedema Network’s Position Paper on Healthy Habits and Lymphedema as well as Risk Reduction.3 To receive tips about swelling and news about upcoming video posts, ebook updates, classes and group interactions with others, click here.
1 Foldi, M, Foldi, E. (2006). Foldi’s Textbook of Lymphology (2nd ed.), p. 224. Germany: Urban and Fisher.