Authors (including presenting author) :
Lee HKA (1), Ku SLO (1), Kwok PY (1), Wong KH (1)
Affiliation :
(1) Stoma and Wound Care, Tseung Kwan O Hospital
Keyword 2: :
Lymphedema management
Keyword 3: :
Nurse care clinic
Introduction :
Lymphedema represents a significant global health challenge, with prevalence at 1.33-1.44 per 1000 populations worldwide. In Hong Kong, its severity is often neglected, and thus delaying optimal treatment timing. CLTC in TKOH has been one of the pioneered nurse-led lymphedema management in Hong Kong since 2013. This study evaluated the clinical effectiveness of the nurse-led clinic for the lymphedema patients.
Objectives :
To evaluate the patients’ clinical outcomes and support ongoing service advancement.
Methodology :
The retrospective analysis reviewed 11 newly referred patients from 2024 to 2025. Demographics, medical history, symptoms, limb circumferences and management data were reviewed.
Result & Outcome :
7 females and 4 males were newly referred in the analysis period, with age ranged from 36-92 years (mean 61.5 years). The referral locations were from TKOH (n=8), PWH (n=1), KWH (n=1) and private sector (n=1). Reasons for referrals included cancer related lymphedema (n=5), trauma related lymphedema (n=2), primary lymphedema (n=2) and axillary web syndrome (AWS) (n=2). The nurse lymphedema therapists assessed their symptoms and measured limb circumferences regularly. Manual lymphatic drainage (MLD), multi-layer inelastic lymphedema bandaging (MLLB), and skin care were performed based on their conditions. Education on self MLD, MLLD and use of pressure hosiery was performed to enhance self-empowerment. During the initial assessment, their symptoms included limited range of movement (ROM) (n=7), pitting edema (n=6), history of cellulitis (n=4), fibrosis (n=3) and one patient had ulcerations for more than 1 year at affected limb with size 9.5x16cm and he required daily dressing in general out-patient clinic due to profound exudate. The mean visits were 9 (range 3-15). In the review, the primary outcome of limb volume measurement was analyzed. Of 9 lymphedema patients, 6/9 (66.7%) achieved a volume reduction at first 1-2 months (-0.4% to -8.3%). After an intensive lymphedema management, 5 patients (55.6%) demonstrated final volume reduction comparing to baseline from -3.7% to -15.5% in the end of 2025, and 8 patients were able to perform self MLD and self-application of MLLD and pressure hosiery. The patient with wounds also healed up within one month after MLD and MLLB. For the two cases referred for AWS, all symptoms were resolved with MLD and exercise. The above findings demonstrated the significant clinical benefits, including limb volume reduction and symptoms alleviation, from lymphedema interventions. Enhanced resource allocation for Integrated wound-lymphedema service is recommended to address growing clinical demand.
