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Compression garments will limit the amount of swelling and thereby slow the advancement of lymphedema, as well as maintain the reduction in swelling achieved following other treatments.
Elastic compression garments such as graduated compression hosiery and arm sleeves are effective in helping promote the venous and lymphatic return by gently compressing the limb with graduated pressure - pressure which is greater distally (direction farthest from the heart) than proximally (direction closer to the heart). The specific external pressure applied to the limb also has a massaging effect on the muscle pump. Elastic stockings and arm sleeves are primarily designed to maintain and support the limb, not to reduce its size. Garments should be applied in the morning to prevent gravity from pulling fluid down into the limb. They should be worn daily while active, and removed for sleeping when the body is recumbent and the stronger external pressure of elastic garments is not necessary. Elastic stockings and arm sleeves are an essential adjunct to manual lymph treatment, compression bandaging at night, and compression pumps.
Compression hosiery can be custom made to your measurements, or ready-to-wear depending on the size and shape of your limb. Compression hosiery today is considered cosmetically acceptable, is available in many styles and colors, and patient compliance is excellent.
Custom and Prefabricated Compression Hosiery:
•Thigh with waist attachment (chap style)
•Pantyhose and leotards
•Custom and Prefabricated Lymphedema Sleeves:
•Arm sleeve with glove or gauntlet attached
•Arm sleeve with shoulder flap
•Arm sleeves, wrist to axilla with or without silicone border
•Custom and prefabricated lymphedema gauntlets
•Custom and prefabricated lymphedema gloves
•Jobst Elvarex® custom lymphedema garments
•UlcerCare Stockings, liners and dressings
•Lymphedema bras and vests
•Hosiery Colors: beige, black, navy, brown, ivory and white
•Special Accessories: application gloves and slippers, cold water washing solution, garter belts, It Stays© roll on body adhesive
•Lotions and creams compatible for use with elastic hosiery
Short stretch compression bandages are minimally elastic. They compensate for the diminished skin pressure associated with lymphedema, and prevent the reaccumulation of evacuated, stagnating lymph fluid. The more inelastic the bandage is, the greater the potential working pressure (pressure produced when the muscle pump works against the resistance of the bandage, as when exercising). Inelastic and short stretch bandages have advantages over elastic garments because they force a higher working pressure and greater muscle pump efficiency. Conversely, because of the low resting pressure (pressure exerted when the muscle is inactive and relaxed), compression bandages may be worn day and night with good patient compliance.
Compression bandaging is applied in layers. The digits (fingers and toes) are individually wrapped with gauze bandages. A tubular bandage, made of primarily cotton, is worn underneath the compression padding and bandages to protect the skin and absorb excess perspiration. Padding bandages are applied just prior to the actual compression bandages to cushion the limb (especially over skin creases or bony prominences) and to prevent sharp indentations and irritations to the skin. In addition, they serve to distribute the pressure evenly over the limb. The last stage is the actual short stretch compression bandages used to apply the final compression. They are wrapped with mild to moderate tension in an overlapping pattern in a distal to proximal direction.
CircAid® Arm-Sleeves and Leggings are non-elastic, and are an alternative to bandaging. They are considered easier to apply, and have the advantages of non-elastic compression- high working pressure and low resting pressure. CircAid® System is a unique, adjustable band closure system of inelastic Velcro strips. Compression levels can be sustained even when the limb size is reduced by simply re-adjusting the Velcro strips, rather than completely re-wrapping the limb with bandages. Because the bands are non-stretch, there is no reduction in compression regardless of the age of the device, unlike compression bandages and hosiery which lose their compression over time.
Compression pumps are designed to promote venous and lymphatic circulation, and remove edema from the extremity by progressively moving fluid in a distal to proximal direction. The effect of the mild intermittent pressure is to increase interstitial pressure, thereby driving intercellular fluid into the venous capillary system. The most effective pumps are multi-chambered, and deliver calibrated, gradient pressure. Pumps are generally viewed as being most effective when combined with other treatment methods such as manual lymph treatment which prepares the quadrants near the affected limb to be able to accept the excess fluid being forced out of the limb and to transport the lymph to a cluster of operative lymph nodes. Treatments should then be followed with compression bandaging or garments to maintain the results.
Directional Flow Compression Systems (JoViPak® & Tribute) , sleeve-like units filled with hundreds of foam polyurethane chips to cover edematous or indurated tissue. These devices are designed so that the soft outer fabric is stitched in elongated channels which simulate the recommended pattern for manual lymph treatment. Thus, when external pressure is applied to reduce the effects of swelling, these devices not only cushion the area, they facilitate the entire remedial process, also helping to prevent or relieve fibrosis. This system should be used under short-stretch bandages, with a pneumatic compression pump or under an outer compression binder.
Lymphedema Bras : offer fashionable comfort and gentle compression for swelling due to chest and breast lymphedema.
ReidSleeve®, a device utilizing special convoluted foam with areas of high and low pressure to provide a gentle, gradient pressure to increase lymphatic outflow. Pressure is applied by a series of straps and is regulated with the use of a special gauge.
NightSleeve™, made of one-way stretch, multi-layered material that applies pressure throughout the sleeve, thereby gently and comfortably evacuating fluids and preventing their return. This is a simple and effective alternative to cumbersome bandages .