Lymphorrhoea (Leaky Legs): Practical Management and the Role of Compression
What do “leaky legs,” wound exudate, and chronic oedema have in common—and why do so many people continue to struggle with them despite ongoing treatment?
In this episode of Lymphoedema Insights for Health Professionals, Maree O’Connor is joined by Stacey Bradshaw, Occupational Therapist, wound care clinician, lymphoedema practitioner, and educator, to unpack the practical realities of managing lymphorrhoea.
Drawing on nearly two decades of clinical experience, Stacey explains why lymphorrhoea occurs, the impact it can have on skin integrity, wound healing, mobility, and quality of life, and why effective compression therapy remains the cornerstone of management. Together they explore common misconceptions, frequent treatment pitfalls, and the reasons some people experience ongoing leakage despite receiving care.
The conversation also highlights how clinicians can confidently identify lymphorrhoea, when specialist referral is warranted, and the role accredited lymphoedema practitioners play in selecting compression solutions that are both effective and sustainable.
If you work with people living with lymphoedema, chronic oedema, venous disease, wound complications, or age-related swelling, this episode offers practical insights that can immediately inform clinical decision-making and improve patient outcomes.
About our guest speaker: Stacey Bradshaw
Stacey Bradshaw is an Occupational Therapist with nearly 20 years of experience in lymphoedema management, chronic oedema, and wound care. She is the Owner and Lead Educator of the Australian Institute of Lymphoedema and a former Vice President of the Australasian Lymphology Association.
Throughout her career, Stacey has led complex outpatient lymphoedema services, developed multidisciplinary approaches to lower limb oedema and wound management, and provided education and mentoring to health professionals across Australia. She holds a Master of Wound Care from Monash University and represents Wounds Australia on the European Wound Management Association’s International Expert Working Group for Compression Therapy.
Stacey is recognised for her practical, evidence-informed approach to compression therapy, oedema management, and wound care, making her a sought-after clinician, educator, and speaker in the field.
Sponsor
This episode of Lymphoedema Insights is proudly supported by Essity.
Through JOBST and Cutimed, Essity Health & Medical supports the management of lymphorrhea by combining compression and advanced wound care solutions. Compression garments such as JOBST FarrowWrap and Elvarex Soft help control oedema, while Cutimed Sorbion superabsorbent dressings manage heavy fluid leakage, and Cutimed Sorbact safely reduces bacterial load.
Together, these solutions form part of Essity’s comprehensive lymphoedema portfolio.
To explore the full range and clinical resources, visit medical.essity.com
🎧 Listen to Episode 15
Key Takeaway Messages
Lymphorrhoea is a sign of uncontrolled fluid accumulation. It occurs when excess interstitial fluid cannot be adequately returned via the lymphatic system and begins leaking through the skin.
Differentiate lymphorrhoea from wound exudate. Wound exudate comes from a wound; lymphorrhoea describes lymph fluid leaking through the skin. Both can occur together, particularly in people with significant lower-limb oedema and wounds.
Look beyond the leak. Lymphorrhoea may occur with conditions including chronic oedema, venous insufficiency, heart failure, hard-to-heal wounds and reduced mobility. Tight, shiny skin and significant swelling may accompany the leakage.
The consequences extend beyond wet skin. Persistent fluid can contribute to skin breakdown, worsening wounds, reduced comfort, odour and substantial impacts on mobility, function and quality of life.
Absorbent dressings manage the fluid; compression addresses the underlying problem. Superabsorbent dressings may be needed initially, but simply containing the leakage does not reduce the oedema that is driving it.
Therapeutic compression is central to management. Stacey emphasises graduated compression, extending from the base of the toes to the knee for lower-limb lymphorrhoea, with sufficient therapeutic pressure to manage the oedema. Light tubular products, crepe bandages or products intended primarily to retain dressings may provide inadequate compression.
Persistent leakage despite “compression” should prompt reassessment. When an appropriate level of therapeutic compression is correctly applied, Stacey describes lymphorrhoea as potentially reducing within hours to days, rather than taking months. Ongoing leakage may indicate that the compression being used is not sufficiently therapeutic or appropriate for the person.
Compression requires clinical assessment and reasoning. Concerns about cardiac or arterial conditions should not automatically result in compression being withheld. Clinicians should use appropriate assessment, relevant guidelines and recognised contraindications and precautions to determine what level of compression is safe.
Stopping the leak does not mean stopping compression. Compression manages the underlying tendency for fluid accumulation; it does not cure the cause. Stacey uses the analogy that compression is like glasses—it works while it is being used. Removing it once leakage or a wound resolves may allow oedema and lymphorrhoea to recur.
The right compression is individualised. Limb shape, severity of oedema, lifestyle, mobility, ability to apply and remove the product, comfort and long-term adherence all influence compression selection. As Stacey puts it: there may be a product for every person, but there is not one product for every person.
Refer when compression management is outside your scope. An accredited lymphoedema practitioner can assess the oedema, consider relevant precautions and select an appropriate compression strategy. The Australasian Lymphology Association practitioner register is identified in the episode as a useful referral pathway.
Effective compression can reduce both clinical and resource burden. Controlling the oedema can reduce leakage, support wound healing and decrease reliance on frequent dressing changes and other consumables.
If the focus remains on absorbing the leakage without adequately managing the oedema, the underlying driver of lymphorrhoea remains untreated.
Catch up
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