Subcutaneous drainage of refractory lower limb oedema at the end of life

Severe, refractory lower limb oedema can be a significant burden for patients with advanced metastatic malignancy. Despite this challenge, management strategies are often limited to analgesia, as well as pressure care and nursing care with positioning and dressings. The evidence for subcutaneous drainage in this setting largely consists of case reports, and it is infrequently practised in palliative care units (PCUs). In this case report, a patient with advanced metastatic ovarian cancer in her final weeks of life is discussed. Her severe lower limb oedema resulted in frequent pain and severe limitations on her mobility. The symptoms resulted in a multidisciplinary approach from the palliative care team, part of which included the use of subcutaneous drainage. The process of initiating this procedure in the PCU, details of the procedure and the benefit from it are described.