Adjustable Compression Wraps (ACW) vs. Compression Bandaging (CB) in the Acute Phase of Breast Cancer-Related Arm Lymphedema Management—A Prospective Randomized Study

Abstract

The objective of this study is to compare the effectiveness, comfort and possibilities of the self-application of adjustable compression wraps (ACW) with compression bandaging (CB) in the acute phase of treatment in advanced upper-limb lymphedema. In total, 36 patients who fulfilled the admission criteria were randomly assigned into ACW-Group (18 patients), or CB-Group (18 patients). Treatment in both groups lasted for two weeks. In the first, all patients were educated in applying adjustable compression wraps (ACW-Group) or self-bandaging (CB-Group) and treated by experienced physiotherapists. In the second week, the use of ACW and CB was continued by the patients themselves at home. In both groups, a clinically significant reduction in the affected limb volume was found after the first week (p < 0.001). A further decrease in the affected limb volume within the second week was noted only in the CB-Group (p = 0.02). A parallel trend was found in the percentage reduction in the excess volume after one and two weeks of compression therapy. Within two weeks, both groups achieved a significant improvement in decreasing lymphedema-related symptoms, but women from the ACW-Group reported complications related to carrying out compression more frequently (p = 0.002). ACW can reduce lymphedema and disease-related symptoms, but based on the results it is difficult to recommend this method as an alternative option in the acute phase of CPT among women with advanced arm lymphedema.

Compression Wraps—Providing Solutions for Complex Lymphatic Presentations

“…Mosti and Cavezzi [17] found that MAC devices were more effective for volume reduction than bandages when used during the initial decongestive treatment phase. Ochalek and Kurpiewska [18] also report clinically significant volume reductions in patients using MAC devices for decongestive treatment; however, in their study, there was an equal or better volume reduction for the patients using bandages. Reißhauser and Kornappel [19] suggest that MAC devices are also effective during the maintenance phase of lymphoedema, particularly for patients who require assistance donning and doffing garments.…”

“…Studies have shown that MAC devices are effective in both the decongestive stage and the maintenance stage of CDT [17][18][19]. Mosti and Cavezzi [17] found that MAC devices were more effective for volume reduction than bandages when used during the initial decongestive treatment phase.…”