Authors (including presenting author) :
Yeung CY(1), Chong HM (1)
Affiliation :
(1) Wound Care Team, NSD, NTWC
Keyword 1: :
Multidisciplinary
Keyword 3: :
Peri-operative Management
Introduction :
Lymphoedema of the lower limb is a chronic, disabling condition that often requires complex, long-term management and can significantly impair mobility and quality of life. Effective care increasingly depends on multidisciplinary collaboration. This case illustrates a coordinated rehabilitation pathway for a patient with lifelong lymphoedema, emphasizing how shared expertise optimizes clinical outcomes.
Objectives :
To illustrate the significant value of wide-ranging collaboration involving eight distinct disciplines in the peri-operative management of massive lower limb lymphoedema. Also, to highlight how synchronizing surgical goals with targeted allied health and nursing interventions maximizes functional recovery, skin integrity, and patient safety.
Methodology :
A 66-year-old woman with lifelong right lower limb lymphoedema was scheduled for liposuction. The Plastic Surgeon directed the pathway, while a Dermatologist managed pre-existing dermatitis. Intensive Multi-layer Lymphoedema Bandaging (MLLB) and Manual Lymphatic Drainage (MLD) was provided by A Certified Lymphoedema Therapist and Wound Care Nurse in both pre- and post-operatively to manage limb volume. Crucially, comprehensive bandage education was delivered to empower the patient with skills for maintenance and enhance self-care continuity. Parallel support included Physiotherapy for mobility, Occupational Therapy for pressure garments, and Dietetics for nutritional optimization. Additionally, the Prosthetist & Orthotist (P&O) designed specialized footwear to accommodate the bandaged limb, ensuring safe ambulation throughout the recovery process.
Result & Outcome :
This accumulated effort prevented complications and ensured continuous rehabilitation. The patient reported high satisfaction with the seamless and holistic care experience. She agreed that the visible teamwork instilled confidence and reduced anxiety. Clinical outcomes included successful wound healing, significant limb volume reduction, and progressively improved mobility observed in the specialty clinic. These positive outcomes have catalyzed the development of a formalized clinical workflow to standardize this high-quality, team-based care for future lymphoedema patients.
