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Chronic oedema is defined as abnormal swelling in the tissues which lasts longer than three months and does not completely reduce overnight or with elevation.

How does chronic oedema occur?

Chronic oedema can occur at any age but is most prevalent in those aged over 65 years due to changes in the lymphatics caused by chronic venous disease, heart disease, orthopaedic surgery, dependency, immobility and infection. (Moffatt et al, 2003).

Morbid obesity is on the increase and it is suggested that 80% of obese people will suffer with lymphoedema, which is difficult to bandage. (Fife 2008.)

Current prevalence rates of 3.99 in 1000 rising to 28.57 in 1000 in the over - 85 age group are still thought to be underestimated. (Moffatt and Pinnington, 2012). (Williams and Craig, 2007)

Causes of chronic oedema

  • Lymphoedema (primary and secondary)
  • Venous oedema - when the valves in the veins stop working properly, this can increase the amount of tissue fluid and cause swelling
  • “Dependency” oedema; associated with immobility
  • Oedema associated with obesity
  • Chronic heart failure resuting in oedema
  • Advanced cancer related to oedema

How is chronic oedema treated?

This depends on many factors, but importantly on the cause of the oedema. Recommended treatment for lymphoedema (primary and secondary) is:

  • Complex Decongestive Therapy (CDT), or also called Decongestive Lymphatic Therapy (DLT). The terms mean the same

There are four components to these therapies:

  • Skin care
  • Manual lymphatic drainage
  • Compression therapy
  • Exercise

For treatment of venous oedema, compression therapy may be used. The two main principles underpinning how compression therapy works are:

  • Counteracting the force of gravity and promoting the normal flow of venous blood up the leg
  • Acting on the venous and lymphatic systems to improve venous and lymph return and reduce oedema

What is the Ideal Compression?

  • Incorporates inelastic and elastic components
  • Conformable, i.e. produces a good anatomical fit
  • Allows full functionality and movement
  • Comfortable at rest
  • Easy to apply and adapt to a range of limb sizes and shapes
  • Non-allergenic and durable

(Fletcher J, Partsch H, Vowden K, Vowden P. 2013)

How does chronic oedema affect quality of life?

Patients can be affected both physically and psychologically, which in turn is likely to impact their quality of life. There are many patient support services across the UK offering patients help and advice on living with chronic oedema. For further information please visit the following links:



What is Lymphoedema?

Lymphoedema is a swelling that develops as a result of an impaired lymphatic system. This may be as a result of the lymphatic system not developing properly or through damage or trauma. Lymphoedema can occur anywhere in the body, at multiple sites or localised. It depends on where there is an impairment in the lymphatic vessels. Recent research suggests that lymphoedema affects at least 240,000 men, women and children in the UK.


  • More common in females. Genetic, congenital abnormality.
  • This is where people are born with an abnormalty in development and or function of the lymphatic system


  • Can be secondary to cancer, infection, radiotherapy trauma, iatrogenic


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Venous leg ulcers

What are Venous leg ulcers?

A leg ulcer is a loss of skin below the knee on the leg or foot which takes more than six weeks to heal.

Interesting facts

  • More women than men suffer with leg ulcers
  • The more pregnancies a woman has had, the greater risk of developing the venous leg ulcers
  • Venous disease may have a genetic component
  • Previous figures suggest between 1.5 and 3 people per 1000 have active leg ulceration
  • Prevalence increases with age to around 20 per 1000 over 80 years
  • The prevalence of leg ulcers in the UK is estimated to be between 0.1% and 0.3%. Approximately 1% of the population will suffer from leg ulceration at some point in their lives

Having varicose veins does not mean venous ulcers will follow. Common causes of leg ulceration include:

  • Venous disease – 60% - 80%
  • Arterial insufficiency
  • Mixed disease
  • Diabetes
  • Rheumatoid arthritis
  • Vasculitis
  • Blood disorders
  • Trauma


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