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What Causes Edema and How Do You Treat It?


When you work in wound care, one of the terms you will likely come across more is the word “edema.”


Edema is common among patients suffering from congestive heart failure, kidney disease, and liver cirrhosis, among others.


Simply put, edema is the swelling of a specific body part usually caused by excess fluid trapped in the body’s tissues. While it can affect any body part, it is commonly found in the hands, arms, legs, feet, and ankles.


What Causes Edema?

Edema is the result of the body tissues’ swelling due to excess fluid retention. It should be noted that the body has two main compartments that exchange fluid. They are the intravascular and extravascular compartments.


The intravascular compartment is made of the vascular system and cardiac chambers, while the rest is part of the extravascular compartment.


Healthy fluid exchange is characterized by easy fluid movement through the body. Fluid is filtered by the hydrostatic and oncotic pressure into the extravascular compartment and then back to the intravascular compartment. The lymphatic system then moves any leftover fluid back into the intravascular compartment.


A change in the balance of these pressures results in the lymphatic system not being able to keep up with moving the excess fluid, thus, resulting in edema.


How Compression Helps

One of the best ways to address edema is through compression. This is because compression helps restore valve competence as well as narrow veins which helps reduce the venous influx. Reducing venous influx helps reduce pain and swelling, heal ulcers, and help prevent their reoccurrence.


Types of Compression

Compression can be categorized into several types and below are some of them.


Unna Boots

This type of compression consists of inelastic gauze infused with either zinc, glycerin, or calamine as well as a cohesive bandage. When dry, the gauze restricts the outward movement of the calf muscle when walking, thereby improving pumping action as well as venous flow. Unna boots are commonly used on ambulatory patients.


Graduated Compression Stockings

If you’re looking for the greatest degree of compression, especially in the ankle area, then graduated compression stockings are your best bet. Designed for ambulatory patients, compression stockings are more appealing to patients. The only downside to this compression type is the risk that comes with it since patients can easily remove them.


Multi-Layer Compression Wraps

Compression wraps usually come in either two, three, or four-layer types which effectively apply sustained compression of up to 40mmHg. Considered the best choice for venous leg ulcer treatment, compression wraps can be left unreplaced for as long as one week depending on the amount of exudate.


Compression Pumps

Last but not least are compression pumps which are used to move excess lymph fluid from the affected area and then back into the cardiovascular system in chronic lymphedema. The procedure is done using a machine pump together with garments applied to the legs.



Final Thoughts

While mild edema usually goes away on its own, the same can’t be said with severe edema which requires immediate and proper care because it can lead to an increased risk of infection, reduced blood circulation, and reduced elasticity of arteries, veins, and muscles, among other things.


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