Background: Lymphedema is a chronic, progressive pathologic condition of the lymphatic system with interstitial accumulation of protein-rich fluid and inflammation, adipose tissue hypertrophy and fibrosis. Protein-rich lymph initiates inflammatory response and increase susceptibility to infections, which can lead to disfigurement or dermal changes. Case Report: A 42-year-old lady was referred to a tertiary care hospital for chronic lymphedema of the left lower limb. She has been having this ailment for the past 20 years, she has a history of traumatic injury of left ankle and the swelling gradually increase in size over the years and developed pulmonary embolism a few years ago. Flap monitoring was done on this patient frequently. During the stay, vacuum assisted closure (VAC) dressing was applied after free muscle coverage of the lower extremity. The patient was given health education on skin care to improve hydration and lower the risk of infection by applying moisturizing emollient to soothe and support the skin. Keywords: Lymphedema, flap care, vacuum assisted closure