APP Session 6: CEAP, Lymphedema and Lipedema Care Update

APP Session 6: Practical Updates in Venous and Lymphatic Care

This session covered topics APPs use daily in a venous and wound clinic: the updated CEAP classification, causes of secondary lymphedema, phlebolymphedema management, and recognizing and treating lipedema.

The 2020 CEAP Classification

A review of the American Venous Forum’s CEAP system walked through each clinical class from C0 through C6, plus the etiology, anatomy and pathophysiology codes used to document severity for compression and ablation approvals.

Secondary Lymphedema

Secondary lymphedema most often follows cancer surgery or radiation that damages lymph nodes, but also arises from infection, trauma, obesity and chronic venous insufficiency. Stemmer’s sign, a positive test on the dorsal toe, helps confirm the diagnosis.

Treating Phlebolymphedema

When venous and lymphatic systems fail together, complete decongestive therapy, manual lymphatic drainage, multilayer bandaging and pneumatic compression pumps reduce swelling and ulcer recurrence.

Recognizing Lipedema

Lipedema presents with symmetric leg enlargement, tenderness and easy bruising, often mistaken for obesity. Conservative care, including compression and diet, comes first; lymph-sparing liposuction is reserved for patients who fail conservative treatment.