Thursday, November 14, 2013

Bandages for Lymphedema

Bandaging is a mainstay of treatment for stage 2 and stage 3 lymphedema (moderate to severe lymphedema). Bandaging involves creating a soft cast on the arm or upper body by wrapping with multiple layers. This is a main component of the larger treatment regimen called complete decongestive therapy, or CDT, and many research studies have demonstrated the effectiveness of CDT. While there aren't many studies that focus just on bandaging, the small amount of research available suggests that bandaging can reduce arm volume.

At first, your lymphedema therapist should do the bandaging for you while teaching you the right technique. Some therapists provide an instructional DVD or written directions to guide you. The process starts with an inner liner made of stocking-like fabric or gauze, also known as a stockinette. The liner would be placed over the arm and hand after moisturizing the skin with a gentle lotion such as Eucerin or Curel. Try to avoid lotions with anything that could irritate the skin, such as perfumes or dyes.

In most cases, padding made of polyester, cotton, or foam would be placed over the stockinette, followed by multiple overlapping layers of short-stretch bandages. Short-stretch bandages look like the Ace bandages you might get at the drugstore, but they're much less stretchy. Generally, there would be more layers further down on the limb and fewer layers higher up, creating graded pressure that helps fluid move up and out of the arm. The bandages should feel snug but not tight.

Bandaging is also an option for lymphedema of the chest or trunk, as short-stretch bandages come in all sizes. Bandaging is a reductive therapy, meaning it makes the limb smaller. When your arm is bandaged, your muscles are "held in" by the multi-layer soft cast every time you use your arm. This is known as working pressure. When you do any prescribed exercises with the bandages on, or simply use your arm as for normal activities, this working pressure creates an internal pumping action that moves fluid out of the tissues and into vessels of the lymphatic system. The bandage cast helps prevent fluid from flowing back into the limb, and it also softens the tissue under the skin. This is why bandages are an important treatment for lymphedema that is causing moderate to severe swelling and/or soft tissue changes.

It is recommended to work with a certified lymphedema specialist to create a tailored plan to treat and manage your lymphedema. We have several certified lymphedema specialists on our Ricky Knowles Hair & Wellness team. Our therapists will work with you to address any problem areas and our certified compression garment fitter, Kristen, can create custom compression wear to help you improve your condition and mobility.

To schedule a free consultation, call a RNHW team member at 713-623-4247 today!

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