Chance of occurrence of postoperative upper limb lymphatic lymphedema: According to incomplete statistics, about 20-30% of patients after radical breast cancer surgery will develop upper limb lymphedema. This is because the surgery removes the axillary lymph nodes and radiation treatment further destroys the lymphatic vessels, triggering edema due to blocked lymphatic return. The timing of the onset of lymphedema is variable, with some occurring as soon as 1 or 2 years after surgery and others after 10 years. Most patients experience swelling of the arm immediately after surgery, but this is not lymphedema and the swelling will soon subside. Any persistent edema that does not subside thereafter should be cause for alarm and early medical attention. Why does upper limb edema occur? Lymphedema is caused by the absence or blockage of lymphatic vessels, which obstructs the return of lymphatic fluid and causes a large amount of body fluid and protein to accumulate under the skin. Mastectomy causes damage to the local lymphatic system due to the removal of surrounding lymphatic tissue, and the effect of postoperative radiation therapy and wound infection makes lymphedema one of the inevitable complications. The upper limb edema after breast cancer surgery is mainly caused by the obstruction of lymphatic reflux after axillary lymph node removal. Clinically, it manifests as different degrees of swelling and pain in the affected upper limbs from the upper arm to the forearm and even the hand. If there is a small local wound, the edematous upper extremity with low local resistance can easily be infected and cause acute lymphangitis, commonly known as “fire flow”. The patient’s upper extremity skin is red, painful, and painful, with a dermatitis-like appearance, and in severe cases, a generalized fever, which requires antibacterial medication to improve. If recurrent, it will aggravate the edema of upper limbs. Most breast cancer patients have mild upper limb edema at the beginning, which does not affect the function of the upper limb and does not require medication. Why is this so? Because lymphatic reflux surgery generally involves sweeping the lymphatic group around the axilla, one stop sweeping, let’s say a pipe with a smooth flow of water, but the flow of water in the pipe is blocked due to improper habits, and once this situation occurs, it is very difficult to carry out treatment again. It is relatively easy to prevent edema, but it is quite difficult to treat edema, which is a world problem and the reason why the medical profession emphasizes that prevention is more important than treatment! Currently, lymphedema does not have a complete cure in clinical practice. Since upper limb edema is poorly treated, it is important to know how to prevent it. Theoretically, two principles should be followed: 1. Avoid excessive blood flow in the upper extremities, because increased blood flow must increase the production of lymphatic fluid, thus increasing the burden of lymphatic circulation. For example, high-intensity upper extremity exercise, infection and high temperature, etc. 2, to avoid increased resistance to lymphatic reflux. For example, too tight clothes can compress the supraclavicular region, and infection in the upper limbs can cause local tissue fibrosis and lymphatic vessels narrowing. Based on the above two principles, breast cancer patients should pay attention to the following after treatment: 1) prevent injury and infection in the affected upper limb; 2) avoid drug injection, blood sampling, immunization and blood pressure measurement in the affected upper limb; 3) avoid high temperature in the affected upper limb, such as hot water immersion, sun exposure and sauna; 4) avoid wearing tight underwear, necklaces and halter bras; 5) avoid high-intensity exercise and heavy lifting in the affected upper limb. Avoid high intensity exercise, heavy lifting and other activities on the affected upper limb. The existing treatment measures mainly focus on stopping the deterioration and improving the symptoms, and are not effective for severe upper limb edema in the late stage. The main measures are: 1. Skin care: The main purpose of skin protection measures is to prevent infection, because the tissue interstices of lymphedema are rich in protein, and a small skin break can lead to bacterial infection. Therefore, trauma, blood sampling, injection, blood pressure measurement or intravenous injection of the affected limb should be avoided; avoid carrying heavy objects and prolonged draping of the affected limb; avoid insect bites and prevent skin injury, and skin injury should be treated immediately once it occurs. 2, the affected upper limb functional exercise: moderate activity and exercise can help improve lymphatic circulation. Such as lazy back, abdominal breathing can change the pressure in the thorax and promote lymphatic reflux. Upper limb lifting exercise can make muscle contraction to stimulate lymphatic flow. However, too strong exercise or static activities (such as carrying heavy objects) can cause overloading of lymphatic vessels and aggravate upper limb edema. Remember not to overdo the exercise, but to do it gradually. The following exercises can help you restore the function of your upper limbs and reduce the incidence of edema. When exercising, you should insist on moving from the distal to the proximal end of the affected limb (from the wrist joint to the elbow joint to the shoulder joint) and following a reasonable method of exercise. 3.Massage: It is the most important means to treat lymphedema at present. Through massage, the lymphatic vessels of the surrounding tissues are emptied first, so as to accelerate the lymphatic fluid return of the affected upper limb. However, massage should be carried out by experienced professional masseurs. 4.Pressure gloves: Wearing pressure gloves can prevent lymphedema and avoid worsening of swelling. Pressure gloves can be pressed against the swollen area to avoid the accumulation of body fluid; at the same time, as a support for the affected limb to help the muscle pump away body fluid. The compression glove is specially designed so that the pressure is concentrated on the lower part of the arm to facilitate fluid drainage. 5.Pressure pump therapy: that is, using a lymphedema machine. An inflatable cuff is placed on the edematous limb and inflated intermittently to allow the edematous fluid to flow centripetally. Most of these air pressure devices are multi-chamber, sequential, adjustable pressure gradient pumps. The pump pressure decreases centripetally like a wave, squeezing the edema fluid into the blood circulation. This method has certain efficacy in the early stage of lymphedema and before the occurrence of obvious subcutaneous fibrosis. 6.Air wave pressure therapy instrument (IPC for short) is a very safe and economical physical therapy recognized worldwide for activating blood circulation, driving blood circulation in limbs, preventing muscle atrophy and preventing deep vein thrombosis. Airwave pressure therapy instrument uses intermittent pressure to treat venous and lymphatic system dysfunction, which can significantly promote lymphatic and venous reflux, play the effect of eliminating edema and activating blood circulation. For all kinds of lymphedema 3/5 can be cured and 2/5 need long-term maintenance treatment. Eliminate lymphedema with immediate effect, reduce swelling and pain, disappear or significantly reduce self-conscious symptoms, comfortable legs and feet, 3 times blood flow, accelerate oxygen consumption and metabolism, relieve mental stress and improve sleep. The treatment principle of air wave pressure therapy instrument: air wave pressure therapy instrument uses larger air pressure to repeatedly pressurize and unpressurize the lymphatic fluid and venous blood from distal to proximal order to pressurize the diseased limb, which reduces the pressure in the limb end tissue, and within the time of gas evacuation, the arterial blood supply is enhanced, which rapidly and effectively improves the ischemic and hypoxic state of the limb tissue. Sequential compression of the limb, in the process of accelerating the return of venous blood and lymphatic tissue fluid, enables the removal of local metabolic products and inflammatory pain-causing substances and facilitates the recovery of peripheral neuritis.