Frequently Asked Questions
Find answers to common questions about wound healing and lymphoedema treatment at Pioneer Wound Healing & Lymphoedema Centres. Get expert insights and advice. Topics include leg ulcers, surgical wounds, pressure ulcers, traumatic wounds and dermatological wounds.
Can I Self Refer to Pioneer?
Yes you most certainly can. We recognise how debilitating these conditions are for patients and their families, that’s why we’re happy to take self-referrals. Simply fill in the referral form to send us your details and photographs and one of our team will get in touch.
Can Lymphoedema be cured?
While lymphoedema is generally not curable, it can be effectively managed, and swelling can be controlled. For lower limbs, regular use of compression garments or wraps is often necessary due to the effects of gravity. However, it may be possible to optimise oedema management to the point where compression is not always required, or short breaks—such as for special occasions—can be achieved, though daily use is typically preferable for consistent control.
For oedema affecting other areas, such as the head, neck, breast, or arms, compression garments may not always be necessary. Instead, we can support you in learning self-massage techniques and targeted exercises to manage swelling, using compression as needed.
Do you take referrals from family members?
Yes we do. We know how worrying it can be to see a family member or friend struggling with a chronic wound or Lymphoedema/Lipoedema. We are happy to take referrals from carers, family members or friends, all you need to do is fill in the referral form.
How do I know it’s Lipoedema?
The legs (or affected area) may appear symmetrically swollen, often causing discomfort or pain. You might notice a disproportion between the upper and lower body, with a relatively narrow waist contrasted by a larger hip or buttock area. A common indicator of lipoedema is the “bracelet” or “anklet” effect, as the hands and feet typically remain unaffected. Additionally, the affected areas may bruise easily, with skin that has an uneven, dimpled appearance and have a soft, fluffy texture. There is no definitive test for lipoedema; instead, diagnosis is based on a combination of symptoms identified by a specialist in the field of oedema management.
How is my treatment delivered?
Your treatment can be delivered in a variety of ways. You may wish to attend in person for some or all of your appointments at one of our Centres. Or alternatively, following your initial consultation, we can provide you with a treatment plan so you or your loved one can arrange for some/all of this care to be shared with your local care provider. Virtual video consultations can be arranged if necessary and clinically appropriate.
How long will my treatment take?
Lymphoedema management can be optimised but requires ongoing maintenance to remain effective. Typically, management is divided into two phases: the intensive decongestive phase and the maintenance phase.
The intensive decongestive phase focuses on reducing swelling and generally involves 2–3 weekly appointments for 3–4 weeks. During this phase, treatments may include bandaging, education on lymphatic drainage, exercises, and possibly complementary therapies to support swelling reduction. Alternatively, some patients may opt for self-management using wrap-style garments at home. Once the swelling is reduced to an acceptable level patients move to the maintenance phase. measurements are taken for a maintenance garment.
The maintenance phase emphasizes consistent skin care, simple exercises, self-lymphatic massage, and the regular use of compression garments. Manual Lymphatic Drainage (MLD), a specialised massage technique can also be incorporated during this phase as a way to “top up” maintenance efforts. While some individuals may not require a decongestive phase, others may experience a cycle of decongestion and maintenance depending on the severity and nature of their oedema.
For patients with Lipoedema, a decongestive phase is typically unnecessary, as compression cannot reduce the fat tissues. Instead, the focus is on education about the condition, measurement, and provision well fitting compression garments to support the tissues, prevent it getting worse and improve mobility.
How much will it cost?
Our charges for these services vary based upon the agreed treatment plan and the frequency of follow up appointments.
Patients with Lymphoedema/Lipoedema
| Initial assessment | Follow up appointment |
| £180 | £120 per appointment |
| Full Assessment at a Pioneer Clinic Treatment Plan * |
Following a full assement: Regular appointments at the Pioneer Clinic where specialist review and updates to to Treatment Plan & care are provided. This appointment type can also be booked for Manual Lymphatic Drainage (MLD) treatment. |
Follow up appointments beyond 6 months of the full Pioneer assessment will require a new full assessment.
How quickly are enquiries responded to?
We aim to respond to your initial enquiry as soon as possible.
What are the additional costs?
Potential additional Costs
Most patients with lymphoedema/Lipoedema and those with wounds on the lower leg will require compression garments to improve/maintain their condition. Patients are required to purchase these separately (basic hosiery is around £10 per set but made to measure hosiery can be required to achieve the best clinical outcome and be more than £120 per set – your clinician will discuss the options and their recommendations with you during your appointment).
What are the signs of Lymphoedema?
The first sign of oedema is often swelling in the ankle or back of the hand, which typically resolves with rest and elevation overnight. Affected areas may feel sore, warm, irritated, or appear darker in skin tone. Over time, the swelling can become persistent, firmer, does not go away overnight and changes in the skin can be seen. Addressing this early provides more treatment options, but even in advanced cases, significant improvements can often still be achieved.
What can cause Lipoedema to trigger/occur?
Changes in female hormones, onset is usually observed from birth, puberty, pregnancy or menopause. Occasionally it is observed after an alteration in hormonal birth control contraceptive options or hormone replacement therapy.
What is Lipoedema?
This not the same as Lymphoedema. Lipoedema is a genetic condition that results in uneven fatty tissues deposited around the body and mostly affects women. Often this can be seen at the wrist, ankles and hips. Patients often report these areas as being painful and heavy. We can support you to understand and manage this condition.
What is Lymphoedema?
A build-up of fluid (water and proteins) in the skin tissues that does not go away with rest and elevation.
This swelling can appear anywhere on the body, this can include the face, chest, groin, genitals, arms and legs. This can be hereditary or as a result of other treatments/surgery. This is often a poorly diagnosed condition; we can help with this diagnosis and treatment.
What is Manual Lymphatic drainage (MLD)?
This is a medical massage that manually pushes the fluid out of the tissues. It should be provided by a qualified Lymphoedema Practitioner who understands your condition fully. MLD is offered at Pioneer clinics by qualified Lymphoedema Practitioners. Manual Lymphatic Drainage (MLD) is a specialised massage technique designed to stimulate the lymphatic system and promote the movement of lymph fluid, which helps reduce swelling and support overall lymphatic function. It involves gentle, rhythmic, and precise hand movements performed by trained professionals. MLD can be particularly beneficial during the decongestive phase of lymphoedema treatment to enhance swelling reduction and may also be used as part of ongoing maintenance to prevent fluid build-up.
Currently, MLD for limb lymphoedema is not commissioned by the NHS in most areas. However, it is available privately through Pioneer clinics for those who wish to include it in their care plan.
While MLD can be an effective component of lymphoedema treatment, it is typically most beneficial when combined with other therapies such as compression garments, skin care, and self-lymphatic drainage exercises
What types of conditions do Pioneer treat?
At Pioneer we specialise in treating patients suffering with:
- Leg ulcers
- Pressure ulcers (bed sores)
- Wounds from surgery or procedures
- Wounds on the feet, non-Diabetic and Diabetic patients
- Skin/wound infections (Cellulitis)
- Lymphoedema (persistent swelling anywhere on the body)
- Lipoedema (out of proportion body shape with painful limbs)
- Other skin conditions related to the above
You or your loved one may have been dealing with a wound for a long time and do not yet know the type of wound you have. We can also support you in getting this diagnosis.
Who are Pioneer?
Pioneer Wound Healing & Lymphoedema Centres are the UK’s largest expert wound healing and lymphoedema team and are leaders in the two specialities with many decades of specialist experience between us.