Compression bandaging

Extracts from ILF's document

1. Findings from a recent Cochrane systematic review have shown that bandaging and compression hosiery are more effective at reducing and maintaining limb volume over 6 months than using compression hosiery alone.
2. Bandaging is used throughout the management of lymphoedema
   • Within a period of intensive DLT
   • In combination with compression hosiery/devices in long term management
   • In palliative care to aid symptom control
3. Specialist knowledge and skills are required for safe and effective application
4. Younger patients are requesting the use of bandages they can safely apply themselves. Lack of access to healthcare support will require the lymphoedema community to develop and evaluate effective compression systems that can be safely used in the patient’s home.
5. Chronic oedema and lymphoedema need continuous compression. When compression is discontinued, oedema will recur. This is also true after liposuction and most other surgical procedures.
6. While venous problems are associated with living in the upright position and compression in such patients is mainly needed during the daytime, lymphatic damage preferably requires compression day and night.
7. Self-management is a goal based on important psychological and economic advantages.
8. In clinical practice, especially in lymphoedema bandaging, additional overlapping layers are frequently applied to produce the desired pressure characteristics17. Looking at the measured stiffness, it is obvious that the effectiveness of a properly applied compression system is not determined by the number of layers but by the fact that these layers are applied at full stretch.
9. Inappropriate bandage selection and poor application are probably the commonest reported clinical problems associated with concordance.
10. In many educational tools, bandaging methods are explained in detail. In the majority of these tools, techniques are suggested that require large amounts of a variety of materials, resulting in bulky applications.
11. Now, more than ever, there is a need for cost-effective, time-efficient, compression bandaging systems that are light, flexible and can remain in situ for longer without slippage or loss of pressure to make a major contribution to meeting the challenges of contemporary lymphoedema practice.
12. Compression bandage profiles change over wear time due to oedema reduction (50% pressure drop in 2 hours, two thirds loss after 24 hours).***