Ankara City Hospital, Department of Physical Medicine and Rehabilitation, Bilkent, Ankara, Turkey.
Department of Physical Medicine and Rehabilitation, Kastamonu University Medical Faculty, Kastamonu, Turkey.
Lymphat Res Biol. 2021 Jun;19(3):286-294. doi: 10.1089/lrb.2020.0088. Epub 2020 Dec 2.
Compression is the most important component of complete decongestive therapy (CDT), but there is no standard best method for applying compression. The aim of this study was to evaluate the comparative efficacy of conventional multilayer short-stretch bandaging, and a velcro adjustable compression wrap with regard to volume reduction, ultrasonographic measurements, functional-status, and quality of life (QoL) in the active CDT period of patients with lower limb lymphedema. The demographic and clinical variables of lower limb lymphedema patients were recorded. All patients received skin care education, manual lymphatic drainage, and supervised lyphedema exercises, and were randomly allocated to Group1 (multilayer short-stretch bandaging-Rosidal-K) or to Group 2 (adjustable-compression-velcro-wrap-Circaid Reduction-kit) for a duration of 3 weeks with 15 sessions. Limb volumes were assessed by perometer. Ultrasonographic measurements included subcutaneous soft tissue thickness. The functional disability and QoL were evaluated by the Lower Extremity Functional Scale and LYMQOL-Leg (Lymphedema Quality of Life Questionnaire-Leg), respectively, at baseline, after CDT, and at first-month follow-up. Thirty-six patients (10 male and 26 female) with mean age of 51.6 ± 11.7 years were included. Fourteen patients had primary and 22 patients had secondary lymphedema. The median duration of lymphedema was 68 months. Significant improvements in volumes and ultrasonographic measurments were observed in both groups at the end of therapies, and improvements sustained up to a month. Appearance, symptoms, and overall QoL-subscores were improved only in Group 2. In conclusion, adjustable compression velcro-wrap performed as a part of CDT can greatly reduce the volume similiar to conventional multilayer bandages, as well as improve the QoL. It can be a comfortable alternative to the conventional multilayer bandages in the active treatment phase of the CDT.
压缩是完整消肿治疗（CDT）的最重要组成部分，但应用压缩的最佳方法尚无标准。本研究的目的是评估常规多层短拉伸绷带和魔术贴可调式压缩绷带在下肢淋巴水肿患者的主动 CDT 期间在体积减少、超声测量、功能状态和生活质量（QoL）方面的比较疗效。记录了下肢淋巴水肿患者的人口统计学和临床变量。所有患者均接受皮肤护理教育、手动淋巴引流和监督淋巴水肿运动，并随机分为 1 组（多层短拉伸绷带-Rosal-K）或 2 组（可调节压缩魔术贴绷带-Circaid 减压套件），持续 3 周，共 15 次。使用周长计评估肢体体积。超声测量包括皮下软组织厚度。功能障碍和 QoL 通过下肢功能量表和 LYMQOL-腿部（淋巴水肿生活质量问卷-腿部）进行评估，分别在基线、CDT 后和第一个月随访时进行评估。纳入了 36 名患者（10 名男性和 26 名女性），平均年龄为 51.6±11.7 岁。14 例为原发性淋巴水肿，22 例为继发性淋巴水肿。淋巴水肿的中位持续时间为 68 个月。两组治疗结束时体积和超声测量均有显著改善，改善持续至一个月。仅在第 2 组中，外观、症状和整体 QoL 子评分得到改善。总之，作为 CDT 的一部分的魔术贴可调式压缩绷带可以大大减少体积，与常规多层绷带相似，同时也可以提高生活质量。在 CDT 的主动治疗阶段，它可以作为常规多层绷带的舒适替代方案。
