Combined modality treatment of lymphedema using the Reid Sleeve and the BioCompression/Optiflow System

Abstract

35 patients (16 upper extremity/19 lower extremity) with refractory lymphedema were enrolled on a longitudinal study using the ReidSleeve in combination with the BioCompression/Optiflow system. The primary objective of this study was to evaluate the effectiveness of this combined modality therapy. Patients wore the ReidSleeve at night and used the BioCompression pump with the ReidSleeve Optiflow insert for 2 sessions of 60 minutes during the day with class II compression stocking for the remainder of the day. Among patients with upper extremity edema, the reduction in lymphedema was 24.7, 53.8 and 80.2% at 4, 12 and 28 weeks. Linear regression analysis demonstrates a highly significant (p<0.001) reduction in arm edema during the course of treatment. A plateau phase occurred between weeks 4 and 8 weeks. Among patients with lymphedema edema of the lower extremity, the average reduction was 296, 646, 607, 484, 305, and 884 ml at 1, 2, 4, 8, 12 and 16 weeks respectively. These patients demonstrated marked reductions in lymphedema during the first 2 to 4 weeks followed by a period of relatively stable lymphedema until week 12 with a further decrease in average volume of lymphedema of 14496 cubic centimeters by week 16. Linear regression analysis demonstrates a significant (p<0.001) decrease in leg edema. The ReidSleeve used in combination with the BioCompression/Optiflow system provides effective management for upper and lower extremity lymphedema.

Arm Lymphedema as a Consequence of Breast Cancer Therapy

“…This includes changing compression garments every 4-6 months and equipment replacements and maintenance. Monitoring by a medical profession is, also, essential to the long-term success for lymphedema treatment (Ko, 1998;Hafner et al, 2005;Boris et al, 1994;Johnstone et al, 2006;Lasinski, 2002).…”

“…Phase II is known as the maintenance phase, where the patient self-manages to keep the effects of phase I treatment long term (Szuba, 2000;Hinrichs et al, 2004;Lasinski, 2002;Thomas et al, 2007;Koul et al, 2007). The effects of CDT include decreases in swelling, an increase in lymph drainage from the congested areas, a reduction in skin fibrosis and improvements in the skin conditions, an enhancement in the patient's functional status and quality of life as well as a relief in discomfort, and a reduced risk of cellulitis and StewardTreves-Syndrome (a rare form of angiosarcoma) (Hammer et al, 2007;Mondry et al, 2004;Ferrandez, 1996;Franzcek et al, 1997;Hayes et al, 2008;Ahmed, 2008;Weiss, 2002;Kim et al, 2007;Cormier et al, 2009 ;Hormes et al, 2010 ;Fu et al, 2009;Vignes, 2006).…”

“…The latter come in specialized varieties that better help to maintain the results of Phase I CDT, throughout Phase II. These include Velcro closure and specialized foam compression garments (Lund, 2000;Hafner et al, 2005;.…”

“…Ongoing research has been presented in treatments such as cold laser, electrical stimulation, vibratory therapy, oscillation therapy, endermologie and aqualymphatic therapy and are done in combination with portions of CDT (Piller et al, 2010;Carati et al, 2003;Hafner et al, 2005 ;Tidhar et al, 201;Omar et al, 2010;Jahr, et al, 2008). Acupuncture is shown to ease some cancer and treatment related symptoms such as fatigue, hot flashes, nausea, neuropathy, and muscular or joint pain, but no formal treatment has been devised from acupuncture (Farrow, 2010b).…”