Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey.
Support Care Cancer. 2023 Jun 7;31(7):383. doi: 10.1007/s00520-023-07843-y.
The aim of this study was to evaluate the effect of compression bandage applied with different pressures on the skin and subcutaneous thickness in individuals with breast cancer-related lymphedema (BCRL).
21 individuals with stage 2 unilateral BCRL participated in the study. Individuals were randomly allocated into two groups as low-pressure bandage (20-30 mmHg) (n: 11) and high-pressure bandage (45-55 mmHg) (n: 10). Skin and subcutaneous tissue thickness, extremity volume, sleep quality, treatment benefit, and comfort were evaluated by ultrasound from 6 reference points (as hand dorsum, wrist volar, forearm volar, arm volar, forearm dorsum, and arm dorsum), volumetric measurement, Pittsburgh Sleep Quality Index, Patient Benefit Index-Lymphedema, and visual analog scale, respectively. Complex decongestive physiotherapy was applied to both groups. Compression bandage was applied according to their group. Individuals were evaluated at the baseline, 1st session, 10th session, 20th session, and at 3-month follow-up.
Skin thickness decreased significantly in the volar reference points of the extremity in the high-pressure bandage group (p = 0.004, p = 0.031, and p = 0.003). Subcutaneous tissue thickness significantly decreased at all reference points in the high-pressure bandage group (p < 0.05). In the low-pressure bandage group, skin thickness only decreased in the forearm dorsum and the arm dorsum (p = 0.002, p = 0.035) and subcutaneous tissue thickness changed for all points (p < 0.05) except for hand and arm dorsum (p = 0.064, p = 0.236). Edema decreased in a shorter time in the high-pressure bandage group (p < 0.001). No significant differences were found in sleep quality, treatment benefit, and comfort for both groups (p = 0.316, p = 0.300, and p = 0.557, respectively).
High pressure was more effective in reducing subcutaneous tissue thickness in the dorsum of hand and arm. The usage of high-pressure can be recommended especially in cases which have edema in the dorsum of hand and arm which is difficult to resolve. Also, high-pressure bandage can provide faster edema resolution and can be used in rapid volume reduction as desired. Treatment outcomes may improve with high-pressure bandage without any impairment in comfort, sleep quality, and treatment benefit.
NCT05660590, 12/26/2022 retrospectively registered.
本研究旨在评估在患有乳腺癌相关淋巴水肿（BCRL）的个体中，应用不同压力的加压绷带对皮肤和皮下组织厚度的影响。
21 名患有单侧 BCRL 2 期的个体参与了这项研究。将个体随机分配到两组：低压力绷带（20-30mmHg）（n=11）和高压力绷带（45-55mmHg）（n=10）。使用超声从 6 个参考点（手背部、手腕掌侧、前臂掌侧、手臂掌侧、前臂背侧和手臂背侧）评估皮肤和皮下组织厚度、肢体体积、睡眠质量、治疗获益和舒适度，分别采用体积测量、匹兹堡睡眠质量指数、患者获益指数-淋巴水肿和视觉模拟量表进行评估。两组均采用复杂消肿物理治疗。根据分组应用加压绷带。个体在基线、第 1 次治疗、第 10 次治疗、第 20 次治疗和 3 个月随访时进行评估。
在高压力绷带组，手部和手臂掌侧的肢体参考点皮肤厚度显著降低（p=0.004，p=0.031，p=0.003）。在高压力绷带组，所有参考点的皮下组织厚度均显著降低（p<0.05）。在低压力绷带组，皮肤厚度仅在前臂背侧和手臂背侧减少（p=0.002，p=0.035），除手部和手臂背侧外，所有点的皮下组织厚度均发生变化（p<0.05）（p=0.064，p=0.236）。高压力绷带组的水肿消退时间更短（p<0.001）。两组的睡眠质量、治疗获益和舒适度均无显著差异（p=0.316，p=0.300，p=0.557，分别）。
高压在减少手部和手臂背部的皮下组织厚度方面更有效。在手部和手臂背部出现难以消退的水肿的情况下，可推荐使用高压绷带。此外，高压绷带可以更快地消除水肿，并可以根据需要进行快速体积减少。在不影响舒适度、睡眠质量和治疗获益的情况下，高压绷带可以改善治疗效果。
NCT05660590，2022 年 12 月 26 日回顾性注册。
