The chronic nature of lymphedema means compliance with a treatment plan is critical for patient help — but also challenging.
medi USA, which offers a range of garments for lymphedema care, calls lymphedema “a notoriously debilitating progressive condition with no known cure. For patients suffering from lymphatic disease, compression garments must be comfortable as well as effective.”
medi USA’s mediven 550 bustier.
Compression therapy, says Dean Bender, executive VP of CircAid, “comes in a variety of forms. Typically when you first receive treatment, compression bandages are the mainstay of that acute treatment phase. You’ll go see a therapist, and they will do a combination of a massage technique that’s very different than other massage therapies. You’re not doing deep tissue (massage), because this edema lies just underneath the dermal layer. So it’s a very light massage to help move this edema out of that limb. They’ll do that for about an hour, and then they’re going to wrap the limb in these bandages that are shortstretch bandages; they don’t have a lot of elastic property to them.”
Those types of bandages, Bender says, “essentially holds that limb tight and doesn’t allow that edema to swell. So it continues to push it out of the limb. You’ll see that therapist over a period of time — daily, typically, depending on their status. And they’ll get the limb to what we call a decongested or a reduced state. Then it is at that point that you move into a maintenance garment.”
Compression garments can help to maintain that reduced-edema state and can be used depending on the severity of the lymphedema. “Severe lymphedema requires the most robust material to help manage fibrotic tissue and excess tissue (lobes) that develops over time,” medi USA says, adding that the company offers products to help with both severe and milder cases of lymphedema. Even mild lymphedema cases “are important to manage properly so that they do not develop into more advanced stages.”
Among patients with milder lymphedema, medi USA says it offers the new mediven sensoo material, “designed to provide strong support in the most elastic flat-knit material” and popular “with patients who do not need the stiffest, most stout material. They need a strong material that is easy to apply and elastic enough to don and doff easily.”
CircAid’s compression products have a different design, which Bender refers to as a compression wrap. “Instead of being a stocking that you have to pull over the foot and up the ankle and up the leg, you simply take the product and wrap it around the limb,” he says. “You’re just going to wrap this around the leg, and then (there are) Velcro straps that work the way up the leg. You simply pull those tight. It’s going to behave, once it’s on the leg, a lot like the bandage, because it’s a short-stretch bandage. But now instead of having to wrap up the leg and around the leg, all you do is pull those straps closed.”
CircAid’s Juxta-Fit lower legging with attached knee piece.
Whichever products a lymphedema patient and his/her healthcare team choose need to fit not only the patient’s ongoing clinical needs, but also fit into daily activities and lifestyle to have the best chance of continuing usage. Bender pointed out that patients who don’t adhere to the compression regimen face potentially serious repercussions starting with increased limb swelling.
“There are also more severe consequences of being non-compliant,” he says. “Your lymphatic system is tied to your immune system. If you’re not managing your lymphatic system very well, then your immune system breaks down, and you start to develop cellulitis, infections in the skin, which typically requires hospitalization. So it can be very costly, and it can be life threatening if that infection is not kept under control.”
