Edema in Chronic Wounds: Symptoms, Risk Factors, and Treatment

1. Edema in Chronic Wounds: Symptoms, Risk Factors, and Treatment Edema is the medical term for swelling that occurs when excess fluid is present within or around body cells or tissues caused by an injury or inflammation. Though it can affect any part of the body, it occurs more in hands, arms, feet, ankles & legs. Any type of medication, pregnancy, infections, and many other medical issues can cause tissue edema. By taking medication to remove excess fluid and by reducing the quantity of salt in your food, a patient can cure this condition. Since tissue edema is an underlying disease, it requires extra medical care & attention under the supervision of Wound Care Experts, otherwise, it slows the tissue healing process. What Causes Edema? Edema occurs when small blood cells in the body leak fluid that further starts accumulating in surrounding tissues, leading to swelling. It has many possible causes such as: ● Sitting or staying in one position for longer hours ● Weakened valves of the veins in the legs (A condition called venous insufficiency). ● Eating salty food ● Certain diseases, such as congestive heart failures, or lung, liver, kidney, and thyroid diseases, etc. ● Any medications for blood pressure or to control pain. ● Any allergic reaction, extreme burns, trauma, life-threatening infection, or poor nutrition can cause edema. ● Being pregnant can also cause edema in the legs due to the uterus pressure on the blood vessels. ● A blood clot in the deep veins of the legs can cause edema. What Are Risk-Factors of Edema? The risk factors of edema include: ● High blood pressure medication ● Trauma ● Surgery ● Chronic wounds ● Heart failure and kidney disease

2. ● Certain diabetes medications such as thiazolidinediones ● Chronic venous insufficiency ● Lack of protein ● Drugs such as steroids, anti-hypertensive medication, estrogen, etc. What Are The Symptoms Of Edema? The symptoms of edema depend on the amount and location of swelling a patient has. Here are the symptoms of edema: ● Swelling or puffiness of the tissue underlying the skin especially in legs and arms. ● The swelling area might look stretched and shiny. ● Shortness of breath, and chest pain ● Inconvenience in walking if legs are swollen ● Skin that retains a dimple after a few seconds of pressure ● Abnormal weight gain or loss ● Decreased urine production ● Increased abdominal size etc. If a patient notices any of these symptoms, he/she needs to immediately see Bedside Wound care services. The experienced & expert team of doctors, nurse practitioners & surgeons will evaluate the wound condition and generate an effective & customized treatment plan focused on quicker wound healing & the patient’s overall comfort.

3. What Are The Types Of Edema? Edema can be categorized depending on its impacts on certain parts of the body. For example: ● Peripheral - Usually it affects the legs, feet, and ankles, but it can also affect arms and can further lead to issues with the circulatory system, lymph nodes, or kidneys. ● Pedal -It usually occurs in older or pregnant patients when the fluid gathers in the feet and lower legs. ● Lymphedema - A damage to the lymph nodes (tissues that filter germs and waste from the body) leads to swelling in the arms and legs. Damage can be caused by cancer treatments like surgery and radiation. ● Pulmonary -It occurs when the fluid collects in the air sacs in the lungs, leading to shortness of breath especially while lying down. ● Cerebral -It is a very serious condition as the fluid builds up in the brain. It can happen due to a head injury or if a blood vessel gets blocked or burst. ● Macular - It is a condition where the fluid builds up in a part of your eye known as macula due to damaged blood vessels. How Is Edema Diagnosed? To diagnose whether a patient has edema or not, the doctors will perform a physical test and ask patients questions about medical history. Along with the suggestive clinical signs, & symptoms, radiological investigative approaches are also used. For example, X-rays, ultrasound, MRI, CT-Scan, blood tests or urine analyses, etc. How Is Edema Treated? Depending on the outcomes of diagnosis, the Wound Care Surgeons will try to determine whether it is temporary or permanent coupled with its causes. ● Mild edema usually heals on its own but more severe edema, for example, due to congestive heart failure or liver disease may be treated by using medication to help the body release excess fluid in the form of urine ie diuretics. ● If edema is caused by a block in fluid drainage, it is treated by blood thinners to break down the clot and get drainage back to normal. ● In case edema is caused by lung disease, the patient is asked to quit smoking.

4. ● Any type of chronic medical condition like diabetes, hypertension, and arterial or venous disease that increase the risk of developing edema, adequate management on these conditions reduces tissue edema. For patients with chronic diseases, limiting sodium/salt intake in the diet can help a lot. In addition to treating these underlying diseases, there are some other steps that a patient can take to prevent fluid from building up in the body. For example: ● Wear compression stockings to improve circulation. ● Vascular surgery ● Increase blood protein levels ● Avoid standing or sitting for long periods of time ● Put a pillow under your legs while lying down. ● Follow Bedside Care specialists’ instructions properly. ● Protect swollen areas from additional pressure, injury, and extreme temperatures. ● Call doctors immediately if patients notice any pain, redness, or heat in a swelling area or even shortness of breath or swelling in one limb. When To See A Doctor? The patients need to schedule a bedside appointment with a doctor if they notice swollen, stretched, or shiny skin, or skin that retains a dimple after putting pressure. See your doctor immediately in case of: ● Shortness of breath ● Chest pain or ● Difficulty in breathing etc. In addition to the treatment, there are some lifestyle changes also that can help prevent edema from developing such as staying physically active and limiting salt intake, etc.