Early results in this small audit demonstrate that this adjustable Velcro compression wrap may provide a simple, clinically effective and patient-acceptable solution for self-care with compression. Use of this type of device could have the potential to reduce overall health-care burden by reducing necessary skilled treatment visits and/or cost while still achieving good clinical outcomes. Further studies are required to confirm this pilot study and provide additional data.

The aim of this study was to gain a comprehensive insight into the use of night-time compression in the management of lymphoedema in patients who had been suffering from chronic lymphoedema for over 12 months. Data were collected and analysed from 94 patients, across five countries. Understanding user characteristics provided insight and understanding into how night-time compression regimens were initiated, products were used and benefits to the patient were reported. In addition to gaining an insight into user habits and night-time compression benefits, unmet needs were also identified. Positive outcomes from the use of night-time compression were reported, with all patients identifying benefits of using night-time compression. An increase in swelling was documented in 89% of all patients in this study group when night-time compression was not used. The study provided an opportunity to explore how lymphoedema affects patients, and how night-time compression can form part of a beneficial regime.

late stage lymphoedema; inelastic bandages; excess limb volume; clinical audit; compression therapy j. whitaker, 1 msc, rn, director, northern lymphology limited/ senior lecturer; a. williams, 2 phd, rn, msc, rdn, rnt, lymphoedema nurse consultant; d. Pope, 3 rn, lymphoedema nurse, previously northern lymphology; r. elwell, 4 rn, msc, macmillan lymphoedema nurse specialist; M. Thomas, 5 mBe, mcsp Bsc (hons) physiotherapy, national clinical lead for lymphoedema in Wales, H. charles, 6 phd, rn independent tissue viability consultant; j. Muldoon, 7 rn, msc, head of clinical research;

Aim: Lymphoedema is associated with dysfunctional lymphatics, tissue fibrosis and inflammatory changes in the skin and local tissue. Ensuring compression supports tissue health is crucial to managing lymphoedema. Providing patients with safe compression which enhances their tissue health is paramount when supporting their 24-hour self-management regimens. This case study explores the use of a new compression garment in two sitting positions in an adult with primary lymphoedema. Method: An 18-year-old female (body mass index 25.2 kg/m2) with Milroy's disease was recruited. She attended two separate 1-hour sessions to evaluate tissue oxygenation (StO2) in chair-sitting and long-sitting (sitting up with a supported back and legs horizontal) positions. Following removal of her usual class 2 (20–30 mmHg) flat-knit compression hosiery, StO2 was recorded for 20 minutes: pre-, during and post the application of an adjustable compression garment (Lohmann & Rauscher) to the right leg. Results: In the long-sitting position, StO2 levels started high at baseline (94.5%), and were relatively maintained both during and post-a short 20-minute intervention (94.1%). In the chair-sitting position, StO2 levels were significantly lower at baseline (52%), showing a 77% increase during the intervention (92%), followed by a small 9% decrease post-intervention (83.7%). Conclusion: This compression garment significantly increased StO2 levels in the chair-sitting position, while maintaining the effects of the patient's compression stockings, in the long-sitting position. Similar to non-lymphoedematous limbs, the patient's normal prescription hosiery maintains StO2. Through implementation of the short intervention sessions, night compression garments may have the potential to improve tissue health in individuals with primary lymphoedema, encouraging self-management and offering a potential night compression solution where the need arises in a 24-hour management plan.

Managing lymphoedema of the male genitals is challenging, distressing and potentially life-threatening if not managed appropriately. Consideration is made of the classification, clinical presentation, lymphatic anatomy and management of genital lymphoedema in clinical practice. The article addresses the Issues raised when caring for patients suffering from this condition. A case history demonstrates the use of a novel innovation. The Whitaker Pouch, which can relieve and manage symptoms facilitating self-management and appropriate best practice.