Lymphedema Diagnosis and Treatment

Publication Date: March 8, 2022
Last Updated: March 23, 2022

Statements Addressing Common Risk Factors for Lymphedema

  • Cancer-related therapy is a common risk factor for lymphedema.
  • Infection is a common risk factor for lymphedema.
  • Chronic venous insufficiency is a common risk factor for lymphedema.
  • Surgery is a common risk factor for lymphedema.

Statements Addressing Diagnosis and Evaluation

  • Clinical examination is sufficient for the diagnosis of lymphedema.
  • Patients with lymphedema should have quantification of swelling.
  • Radionuclide lymphoscintigraphy should be recommended for patients with suspected or diagnosed lymphedema.
  • All patients with CVI (C3-C6) should be considered as lymphedema patients.

Statements Addressing Treatment

  • Regular use of compression garments reduces progression of lymphedema.
  • The choice of circular versus flat knit elastic compression is dependent upon the severity of lymphedema and limb shape.
  • Adjustable (Velcro) devices should be the first treatment for lymphedema patients.
  • Sequential pneumatic compression (SPC) should be recommended for lymphedema patients.
  • Sequential pneumatic compression should be used for treatment of early stages of lymphedema.
  • Manual lymphatic Drainage (MLD) should be a mandatory component of the management of patients with lymphedema.
  • Manual Lymphatic Drainage should be used in the early stages of lymphedema.
  • Surgery should be considered for patients with failed conservative treatment in higher than the second ISL stage.

Recommendation Grading




Lymphedema Diagnosis and Treatment

Authoring Organizations

Publication Month/Year

March 8, 2022

Last Updated Month/Year

August 14, 2023

Document Type


Country of Publication


Document Objectives

Lymphedema imposes a significant economic and social burden in modern societies. Controversies about its risk factors, diagnosis, and treatment permeate the literature. The goal of this study was to assess experts’ opinions on the available literature on lymphedema while following the Delphi methodology.

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Diagnosis, Assessment and screening, Treatment, Management

Diseases/Conditions (MeSH)

D008209 - Lymphedema



Source Citation

 Lurie F, Malgor RD, Carman T, et al. The American Venous Forum, American Vein and Lymphatic Society and the Society for Vascular Medicine expert opinion consensus on lymphedema diagnosis and treatment. Phlebology. March 2022. doi:10.1177/02683555211053532