Physiotherapy intervention reduces incidence of cellulitis and antibiotic use in patients with lymphoedema: A service evaluation.

Abstract

Objectives Lymphoedema is a chronic, progressive condition which results in significant management problems for both patients and clinicians. The main physical complications that is commonly seen in patients with lymphoedema is the development of cellulitis. This paper aims to investigate any potential treatment benefits of the service with a focus on cellulitis. The Lothian Primary Care Lymphoedema Service (LPCLS) was audited in relation to: a) Lymphoedema-related information b) Cellulitis-related information (precipitating factors, signs and symptoms experienced) c) Incidence of cellulitis d) Antibiotic usage and type e) Treatments received by patients within the LPCLS Design An observational, retrospective audit of all patients (n=315) entering the LPCLS since 2009, who had more than one previous episode of cellulitis prior to entering the service, is presented in this paper. Intervention All patients received a combination of: educational leaflets/videos, self-lymphatic drainage, manual lymphatic drainage, multilayer lymphoedema bandaging, exercise, hosiery and skincare. Treatment was administered through facilitation of patient self-management and community care/in-clinic appointments. Outcome measures Incidence of cellulitis and antibiotic treatment were used as outcome measures to evaluate the effectiveness of the service. Results The results suggest that there was a significant decrease in incidence of cellulitis and the use of oral and IV (intravenous) antibiotics.