title: Treatment and outcomes of head and neck oedema referrals to a hospital-based lymphoedema service.
abstract: A retrospective review of all head and neck cancer-related lymphoedema (HNCRL) referrals from 1 October 2009 to 30 September 2013 was undertaken. HNCRL referrals significantly increased over a 4-year period. Lymphoedema clinic records were manually examined for the presentation of HNCRL, treatments provided, and outcomes. Some 207 HNCRL referrals were received, increasing by 251% from 2009 to 2013. A total of 110 men and 50 women were assessed and treated over the 4 years; 67% were discharged, 26% continued treatment/monitoring by clinic; 8% are deceased. The average time to discharge reduced from 16 to 5 months. From the results, it seems that self-management with exercise and counter-pressure/compression is very effective and the requirement for manual lymph drainage is reduced. There is increased patient engagement with effective self-care. Provision of appropriate education and information facilitated simple, effective self-management. This reduced treatment time, shortened time to discharge and released valuable practitioner time to treat patients with complex oedema.
authors.affiliation: NIHR Clinical Doctoral Research Fellow, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, and Honorary Lymphoedema Clinical Nurse Specialist, Guy's Hospital, London.
authors.forename: Eunice
authors.initials: E
authors.lastname: Jeffs
authors.forename: Martine
authors.initials: M
authors.lastname: Huit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage; D005081:Exercise Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications*; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D008209:Lymphedema / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012017:Referral and Consultation; D012189:Retrospective Studies; D012648:Self Care; D016896:Treatment Outcome
keywords: Education; Exercise; Head and neck cancer; Lymphoedema; Self-management