Debulking and Lymphedema

Debulking is a type of surgery sometimes used in patients with lymphedema, a condition that causes swelling and fluid accumulation in the upper or lower extremities.

Generally, the fluid accumulation associated with lymphedema is treated with compression therapy and compression garments. Bandages or gauze are wrapped around the affected limb, and a supportive stocking or arm sleeve that compresses the lymph and blood vessels is placed on top. This process of wrapping and applying compression garments, though it can sometimes get tedious, helps support the lymph system and helps the person’s body better eliminate the extra fluid buildup.

A person with lymphedema may also need to use a sequential compressive device, or compression pumps, which provide intermittent pressure to the arm or leg to help the body get rid of extra fluid. People with lymphedema slide their arms or legs into a sleeve and turn on the compression pumps. The sleeves inflate with air and add pressure to the limb.

In some cases, though, a person may have such severe lymphedema that he or she may investigate surgical therapies. If a person has oozing, weeping lymph fluid, can’t walk or do regular activities at home, or experiences daily severe pain because of lymphedema, surgical therapy could be an option. Doctors stress that debulking surgery for lymphedema doesn’t cure the condition, and in some cases, it may worsen.

There are several different ways that surgeons may attempt to debulk a lymphedema patient and improve the person’s ability to drain lymph fluid. The most common type of debulking is making a small skin flap and removing a small portion of skin and underlying tissue. Surgeons then close the wound and allow it to heal. A few months later, surgeons repeat the same approach in a different area of the affected limb.

Sometimes suction is used to help with debulking, by using a vacuum to suck up underlying tissue, but lymphedema often comes back quickly after this procedure. And in rare cases, a technique is used to take all skin and subcutaneous tissue from the affected limb. Then doctors graft the person’s cut-away skin back onto the body. There are many life-threatening complications associated with this type of surgery.

In all cases, there are serious complications associated with debulking and lymphedema. A patient may experience nerve damage, increased risk of bacterial infection, ulcers, large scar tissue formation, weeping sores, and cosmetic skin problems after debulking.

Note: All information on About Compression Stockings is for your education purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor or health care provider.