Approximately 50 percent of the reduction resulting from Combined Decongestive Therapy for Lymphedema patients is attributable to bandages that function as custom-made garments, and continually adapt to the decreasing size of the affected limbs they are placed on. These compression bandages serve three primary purposes. They help increase the muscle pump mechanism’s effectiveness, they assist in increasing the overall tension in the lymphatic limb and reduce ultra filtration, and they support the skin in the reduction process.
Consisting of the absorption layers, the equilization layers, and the compression layers, Lymphedema bandages are best described as multi-layered, low-compression bandages, and consist of up to ten layers, with most in the periphery. Compression of these bandages is achieved by their thickness not by how tightly they are put on the patient.
Directly in contact with the skin, the absorption layers main purposes are perspiration absorption, irritation minimilization, and comfort increase. The absorption layers of these compression bandages are cotton-based and machine washable. Common materials used in these layers are Stockinette tubular or flat bandages that lack significant compression and Tubigrip tubular bandages that may contain some compression. Tubular bandages are easy to put on the affected limb but may not always be the best fitting. Single layer material provides a more custom fit but requires additional layers for optimum coverage.
The equilization layers of compression bandages are placed over the absorption layers and aid in distributing necessary pressure. Materials that constitute these layers may be foam, which is durable but adds additional thickness to the bandages, or cast padding that typically only lasts for up to four applications. The best materials for the equilization layers of compression bandages are combinations of cast padding and foam. Foam rubber packing materials may be a suitable substitute but patients need to discuss the use of these items with their medical providers. Two layers of cast padding, or one layer of foam throughout the bandages, are normally sufficient.
The compression layers of these bandages provide the actual compression on the affected limb and consists of several layers of short-stretch materials that only provide about 20 percent stretch.
Tape is another supply needed for compression bandages. Paper tape, or masking tape, work better than silk tape and should be used over the elastic clips that are supplied with compression bandages.
Cost Of Compression Bandages:
The cost of compression bandages can average about $100 for each affected limb, and most insurance companies rarely reimburse patients for them, however, it may be possible to include their cost into the price of treatment especially at clinics with large volumes of low-income Lymphedema patients.
Washing Compression Bandages:
It is suggested to not use Woolite when machine washing compression bandages, but to use gentle detergents instead, as this tends to affect the elasticity of the bandages. Completely air dry compression bandages after washing them.
Applying Compression Bandages:
It is essential that compression bandages not be applied too tightly to the patient’s affected limb, and after being applied, they should have a consistency between a regular bandage and a cast. Firm consistency should result when tapping on the applied bandage and a compression range between 30 and 40mmHg should be achieved.
Lymph nodes for Lymphedema patients only work when compressed by message, or compression bandages that firmly fit, as determined by their doctors for the right pressure needed. Doctors should demonstrate for their patients the proper bandaging techniques until they are comfortable bandaging their affected limbs themselves. Doctors also recommend patients wear compression bandages over stockings or sleeves when flying to help reduce swelling and provide additional comfort and support.
Who Wears Compression Bandages:
Stage Zero Lymphedema patients may not require compression bandages. Stage Two and Stage Three patients usually require bandaging during early treatments for Lymphedema. During the Intensive Lymphedema Treatment Phase patients generally wear compression bandages 23 hours a day, 7 days a week.
When Not To Wear Compression Bandages:
Compression bandages should not be worn if the area is infected, if an open wound persist, if the patient is pregnant. or if the patient has heart conditions or Lipedema. Metal clips should never be used to hold compression bandages in place. Patients should avoid wearing compression bandages too tightly to prevent a tourniquet effect on the lymphatic limb that can further damage lymph vessels.
A disorder of adipose tissue that can be inherited, Lipedema occurs almost exclusively in women, and involves excess deposits and expansions of fat cells in unusual patterns. Lipedemic fat can not be lost through diet and exercise, and surgery for it can worsen the condition.
Other Purposes Of Compression Bandages:
Compression bandages control additional swelling, soften fibrotic tissues, accommodate limb size changes as swelling reduces, provide necessary pressure to continue swollen limb reduction, provide increased muscle pump efficiency, and create low resting pressure for inactive and relaxed muscles.
Previously: Manual Lymph Drainage.
Next Time: Lymphedema Association of North America.