Variability in compression pressure of multi-layer bandaging applied by lymphedema therapists

Hara, Hisako; Hamanaka, Nobumitsu; Yoshida, Masatake; Ikehata, Noriko; Tachibana, Shigeko; Nakakawaji, Katsura; Mihara, Makoto

doi:10.1007/s00520-018-4385-9

Cited by 17 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a matter of fact, inelastic bandages are difficult to apply and the target pressure is rarely achieved even by the expert healthcare personnel. [21][22][23] Of great importance, bandage pressure loss has been repeatedly demonstrated in different studies (Figures 1 and 2(a)), which may require a frequent re-adjustment of the bands after a short time, 24 which is not the case with ACW ( Figures 3 and 2(b)) and elastic stockings (Figure 4 and 2(c)). In venous diseases, scientific data on the pressure that is necessary to occlude the veins and exert a hemodynamic effect have been published and debated in the scientific community in the past 20 years.…”

Section: What We Knowmentioning

confidence: 90%

See 1 more Smart Citation

Compression therapy in lymphedema: Between past and recent scientific data

Mosti¹,

Cavezzi

2019

Phlebology

View full text Add to dashboard Cite

Aim To extrapolate and discuss the scientific data on compression in lymphedema treatment, so to review old and innovative concepts about pressure, stiffness and other interplaying factors related to its efficacy and comfort. Material and methods Narrative review based on search in Medline/Google Scholar through key-words related to compression in lymphedema. Results Currently available literature lacks relevant details about data on protocol, devices, techniques, interface pressure, stiffness, as well as biases are represented by the different descriptions to present the outcomes. More recent evidence from adjustable wrap devices and elastic garments question the need for high pressure (especially for the upper limb) and stiffness in lymphedema treatment. Conclusions At present time a very strong compression pressure exerted by material with high stiffness seem to be questionable in lymphedema treatment. A low pressure provides the best outcomes in arm lymphedema, while a pressure in the range of 40–60 mm Hg seems to provide higher efficacy in lower limb lymphedema, provided it is maintained overtime. A high stiffness seems to be unnecessary to treat chronic edema. Future clinical trials, including proper description of treatment methodology and adequate investigating instrumental tools, are awaited to possibly corroborate the conclusive outcomes of our review.

show abstract

Section: What We Knowmentioning

confidence: 90%

“…As a matter of fact, inelastic bandages are difficult to apply and the target pressure is rarely achieved even by the expert healthcare personnel. 21–23…”

Section: What We Knowmentioning

confidence: 99%

Compression therapy in lymphedema: Between past and recent scientific data

Mosti¹,

Cavezzi

2019

Phlebology

View full text Add to dashboard Cite

show abstract

“…Compression pressure was measured with a PicoPress device (Microlab Elettronica SAS, Padua, Italy) (Fig. 1), 18 and the measuring probe was attached to the palmar side of the forearm, 5 cm proximal to the wrist. After the participants applied MLB, the pressure was measured twice: once immediately after applying MLB (phase 1) and again after 10 repetitions of flexing and extending the wrist, elbow, and fingers, as well as in the resting state (phase 2).…”

Section: Methodsmentioning

confidence: 99%

“…We previously reported variability in lower limb MLB pressure applied by lymphedema therapists. 18 However, applying MLB with the necessary and sufficient pressure for treatment is essential to achieving superior results without producing medical device-related pressure ulcers. 19 Thus far, no reports analyzing upper limb MLB pressure variability based on therapist characteristics exist.…”

Section: Introductionmentioning

confidence: 99%

Compression Pressure Variability in Upper Limb Multilayer Bandaging Applied by Lymphedema Therapists

Hara

Yoshida²,

Ikehata³

et al. 2021

Lymphatic Research and Biology

Self Cite

View full text Add to dashboard Cite

Background: Multilayer bandaging (MLB) is often used for lymphedema treatment. Even experienced lymphedema therapists have difficulty applying bandages correctly. The aim of this study was to demonstrate upper limb MLB pressure variability applied by lymphedema therapists. Methods and Results: Twenty-four lymphedema therapists were asked to apply MLB to the healthy volunteer's upper limb. The participants consisted of 20 females and 4 males with a mean age of 43.4 (range: 24-62) years. They included licensed massage therapists, nurses, a judo therapist, an occupational therapist, and a medical doctor. Twenty therapists (83.3%) had clinical experience applying MLB. Compression pressure was measured with PicoPress at 5 cm proximal to the wrist, immediately after the application (phase 1) and after exercise (phase 2). The mean MLB pressure was 67.7 -5.0 mmHg in phase 1 and 55.3 -4.1 mmHg in phase 2, which were significantly different ( p = 1.2 • 10 -10 ). There was a weak negative correlation between how long the therapist had been practicing MLB and MLB pressure (R = 0.29). Seventeen participants (70.8%) expressed that they had a target pressure in mind when performing MLB. Among the 17 participants, there was no correlation between the target and actual pressures (R = -0.055). Only three participants (17.6%) had an actual MLB pressure within 5 mmHg of their target. Conclusions: The mean MLB pressure was 55.3 -4.1 mmHg, which was thought to be too high for the upper limb. Education about applying appropriate MLB pressures to the limbs is necessary.

show abstract

“…Inelastic bandaging is generally used, which has low extensibility and produces high working pressures and low resting pressures, thus stimulating lymph flow. However, Hara et al indicated that the pressure of MLLB varied among therapists and training courses [77]. Furthermore, they found that the most suitable pressure for lymphedema treatment is 50–59 mmHg, which is only achieved by 27.1% of therapists.…”

Section: Treatmentsmentioning

confidence: 99%

Development and Themes of Diagnostic and Treatment Procedures for Secondary Leg Lymphedema in Patients with Gynecologic Cancers

et al. 2019

View full text Add to dashboard Cite

Patients with leg lymphedema sometimes suffer under constraint feeling leg heaviness and pain, requiring lifelong treatment and psychosocial support after surgeries or radiation therapies for gynecologic cancers. We herein review the current issues (a review of the relevant literature) associated with recently developed diagnostic procedures and treatments for secondary leg lymphedema, and discuss how to better manage leg lymphedema. Among the currently available diagnostic tools, indocyanine green lymphography (ICG-LG) can detect dermal lymph backflow in asymptomatic legs at stage 0. Therefore, ICG-LG is considered the most sensitive and useful tool. At symptomatic stage ≥1, ultrasonography, magnetic resonance imaging-lymphography/computed tomography-lymphography (MRI-LG/CT-LG) and lymphosintiography are also useful. For the treatment of lymphedema, complex decongestive physiotherapy (CDP) including manual lymphatic drainage (MLD), compression therapy, exercise and skin care, is generally performed. In recent years, CDP has often required effective multi-layer lymph edema bandaging (MLLB) or advanced pneumatic compression devices (APCDs). If CDP is not effective, microsurgical procedures can be performed. At stage 1–2, when lymphaticovenous anastomosis (LVA) is performed, lymphaticovenous side-to-side anastomosis (LVSEA) is principally recommended. At stage 2–3, vascularized lymph node transfer (VLNT) is useful. These ingenious procedures can help maintain the patient’s quality of life (QOL) but unfortunately cannot cure lymphedema. The most important concern is the prevention of secondary lymphedema, which is achieved through approaches such as skin care, weight control, gentle limb exercises, avoiding sun and heat, and elevation of the affected leg.

show abstract

Variability in compression pressure of multi-layer bandaging applied by lymphedema therapists

Abstract: The pressure of MLB varied in different therapists and different training courses. This fact indicated the necessity of uniform curriculum in training courses including measurement of the bandaging pressure.

Cited by 17 publications

References 14 publications

Compression therapy in lymphedema: Between past and recent scientific data

Compression therapy in lymphedema: Between past and recent scientific data

Compression Pressure Variability in Upper Limb Multilayer Bandaging Applied by Lymphedema Therapists

Development and Themes of Diagnostic and Treatment Procedures for Secondary Leg Lymphedema in Patients with Gynecologic Cancers

Contact Info

Product

Resources

About