What are the recommended first-line treatments for managing lymphoedema in adults?

Recommended first-line treatments for managing lymphoedema in adults include:

• Referral to a specialist lymphoedema service for assessment and discussion of management options as soon as possible after diagnosis. This ensures tailored care including conservative and surgical options if appropriate.
• Compression therapy is offered as the first stage of lymphoedema management. The choice of compression form should be made through shared decision-making with the patient, considering comfort and suitability.
• If compression therapy is not appropriate or not tolerated, kinesiology tape may be considered as an alternative.
• Physical activity, including upper limb exercises, should be encouraged as it does not worsen lymphoedema and may improve quality of life.
• Education on lymphoedema management, skin and nail care to prevent complications, recognition of serious complications (e.g., cellulitis), and support groups should be provided.
• Assessment for other treatable underlying factors such as nodal disease or cellulitis should be done before starting lymphoedema management.

These recommendations are based on NICE guidelines for breast cancer-related lymphoedema management, which are the most relevant UK guidelines available for adult lymphoedema management.

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