“Ask the expert” videos

Dr. Mark Melin on peripheral edema

In this video, Dr. Mark Melin, Vascular Surgeon and Medical Director of the Fairview Wound Healing Institute in Minnesota, offers insights on limb swelling diagnosis and management.

First, Dr. Melin explains that limb swellings can have many different etiologies, and he presents different types of peripheral edemas that exist. He then makes specific recommendations for a differential diagnosis, with a special focus on lymphedema, lipedema, and edemas of venous etiology. “I would challenge my colleagues that I think we under-recognize and under-treat edema within the legs”, states Dr. Melin, thereby underlining the importance of making a correct diagnosis.

Next, Dr. Melin highlights the importance of medical compression therapy for the management of peripheral edema. He also addresses the importance of collaborative work when diagnosing a patient and defining a proper treatment plan. Medical compression therapy “is the foundation of all treatment”, says Dr. Melin, “You need to work with somebody that can properly assess the leg, can properly measure the leg, can properly match your leg to the correct garment for graded compression, because if you have the improper garment on the leg, the adherence rate or compliance rate from the patient is going to be very low. And therefore, you are not going to get the outcome that you expect”.

In addition, Dr. Melin states that it is crucial to “find ways to treat patients where they’re at, to get the best compliance rates”. He highlights the importance of having “a high-quality garment that is suitable and has really good outcomes”.

Finally, Dr. Melin encourages physicians to increase the awareness of peripheral edemas among the wider healthcare community: “We have to be very cognizant and very aware of the presence of edema in the lower extremities and I think we could do a better job from a clinical standpoint of making the diagnosis”.