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Background: While limited information is available, it is possible that high or low sub-bandage pressures cause injury with external coaptation. Fiberglass casting tape is a common splinting material that is custom made for the first bandage and reused in subsequent bandage changes. The aim of this preliminary study was to determine sub-bandage pressure changes in canine hindlimbs between initial splint placement and replacement of the bandage by a different person. The hypothesis was that there would be a clinically meaningful change in sub-bandage pressures with reapplication of the splint in at least one location. Sub-bandage pressures were measured at five different anatomic locations on each of 11 canine hind limbs with dogs standing and in lateral recumbency after customizing a fiberglass lateral tarsal splint for each dog. A second clinician then reapplied the bandage, reusing the same fiberglass splint. Second bandages failed if there was a change in pressure of 20 mmHg at any location. Results: Ten of 11 bandages failed (90%). All but one location failed due to increases in pressure. There were significant changes between lateral recumbency and standing pressures, but there was no consistent pattern of these changes among the dogs. Conclusion: There are changes in sub-bandage pressures when the splint is reused in 90% of bandages. In addition, changes in pressure occur unpredictably when transitioning from lateral recumbency to standing. Further study of the relationship of sub-bandage pressures to bandage complications is vital to help establish safe ranges and inform bandaging improvements. [ABSTRACT FROM AUTHOR]

Traditional lymphoedema bandaging is time consuming and must be applied by experienced accredited lymphoedema practitioners limiting accessibility. However, the emergence of innovative technologies, such as the patented Fast'n Go™ hybrid bandaging system (Thonic Innovation), offers a solution to enhance patient self-treatment options. The single-layer, multi-component short-stretch bandaging system was developed to empower patients with self-bandaging. Online training via YouTube supports the education of accredited lymphoedema practitioners and patients in how to effectively use the system. [ABSTRACT FROM AUTHOR]

Background: The success in multi-layer bandaging (MLB) relies on the technique of the therapists. The purpose of this study was to elucidate the compression pressure of MLB by lymphedema therapists.Methods: We investigated the pressure of MLB applied by 48 lymphedema therapists. The average age was 43.5 (range 23-66) years old. Seventeen (35.4%) of the therapists had the clinical experience of MLB. We prepared ordinary compression materials and asked them to apply MLB to the whole lower limb of healthy volunteers, presuming moderate lymphedema. We attached the probe of Picopress at the Achilles tendon-muscle junction and measured the pressure three times: phase 1, resting condition; phase 2, after ankle exercise; and phase 3, after knee bend.Results: The average pressure in phases 1-3 was 51.9, 48.9, and 45.5 mmHg, respectively. Only 13 (27.1%) of the therapists achieved 50-59 mmHg which is suitable for lymphedema treatment and the pressure varied by the training courses. The pressure decreased as the blank period got longer after finishing training courses (R = - 0.39).Conclusions: The pressure of MLB varied in different therapists and different training courses. This fact indicated the necessity of uniform curriculum in training courses including measurement of the bandaging pressure. [ABSTRACT FROM AUTHOR]

Patients with Grade III or IV contracted ocular sockets, most often due to Post Enucleation Socket Syndrome (PESS), suffer from loss of ocular volume along with a lax lower eyelid, which complicates prosthetic rehabilitation in terms of fit as well as aesthetics. Surgical correction is preferable, though not always feasible. A noninvasive approach for prosthetic rehabilitation of such difficult cases, using bandaging and progressively larger conformers is described here. [ABSTRACT FROM AUTHOR]

In the acute phase of lymphoedema, patients require comprehensive decongestive therapy (CDT), which includes skin care, an exercise regimen, manual lymphatic drainage (MLD) and regular bandaging. This study was established to determine the effectiveness of a new system of bandage therapy, the 3M™ Coban™ 2 compression system. In total, 24 patients were entered into the study (12 from UK and 12 from Canada) with a variety of clinical presentations. The mean age of the groups was 57·4 years, which varied from 26 to 79 years. Body mass index (BMI) averaged 38·9 kg/m2, with a range from 22·7 to 67·5 kg/m2. Of the total, eight were women with arm lymphoedema, the remainder being men and women with lymphoedema of the lower limb. All were considered to be in need of CDT. After 19 days, the reduction of limb volume was measured, which indicated a mean limb volume reduction of 1210 ml (95% confidence interval, CI, 780-1641, P < 0·001). Leg affected patients experienced greater reduction than arm affected patients (1596 ml versus 438 ml), although both groups experienced significant reduction in limb volumes (both P < 0·001). Mean percentage changes in limb volume were 14·9% and 16·1% for legs and arms, respectively. The Measure Your Medical Outcome Profile questionnaire indicated significant improvement in symptoms considered important by the patient ( P < 0·0001), which also led to improvements in skin quality by reducing skin thickness and firmness. The Coban 2 compression system provides good oedema reduction in both arms and legs to reduce limb volume and improvements in symptoms associated with lymphoedema. [ABSTRACT FROM AUTHOR]

There are many fabrics and compression classes to choose from in the treatment of chronic oedema/lymphoedema. This article discusses the techniques involved in producing compression garments, and how different ways of constructing a compression garment can affect the limb being treated. It ends with a short case study describing one patient's experience with layering high compression class garments which did not control his oedema, and how, by changing the garment fabric and reducing the compression class, he has been able to achieve a marked improvement in his general condition. [ABSTRACT FROM AUTHOR]

The article presents a study that compared the efficacy of bandaging and elastic residual limb sock, the two residual limb management methods for persons with transtibial amputation, in terms of residual limb circumferential changes, shape and firmness. Researchers used a prospective two-group experimental design to achieve the desired results of the study. The study found that bandaging application had more residual limb circumferential reduction and improved residual limb firmness and shape.

Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value <0.05) being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value <0.001). Losses of more than 90% of the lymphedema occurred in 9 (39.13%) patients; losses of more than 80% in 13 (56.52%), losses of more than 70% in 17 (73.91%) and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9%) of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effect of a non-occlusive dressing incorporated in a 3-layer bandage on second intention healing of wounds of the distal portion of the limb. Study Design Untreated wounds in 33 adult horses used in four studies using the same wound-healing model conducted over 5 years. Methods Standardised, full-thickness wounds were made in the skin overlying the dorsomedial aspect of the mid-metacarpus; 17 horses were bandaged with a non-occlusive dressing covered by gauze-coated cotton wool that was compressed with adhesive tape; 16 horses were left unbandaged. Wounds were photographed weekly for 9 weeks and the images were analysed electronically. Results There were significant effects associated with bandage (P < 0.0001), week (P < 0.001), and bandage by week interaction (P < 0.0001). There was no difference in wound area at the first time-point after wound creation (P = 0.38). After week 1, there was a difference between bandaged and unbandaged wounds in wound area at each measurement until the end of the study. Bandaged wounds showed greater and more prolonged retraction. Unbandaged wounds retracted for 2 weeks before beginning to contract, whereas bandaged wounds continued to retract for 3 weeks. In bandaged wounds excess granulation tissue required regular trimming, but not in unbandaged wounds. There was no difference between groups in the total days to healing or the overall rate of healing. Conclusions These results should be treated with caution until validated with contemporaneous, controlled studies. Covering a wound with a non-occlusive dressing in a 3-layer bandage led to greater wound retraction, modulated the rate of wound contraction and promoted excessive granulation tissue. If excessive granulation tissue is excised regularly, bandaging has no effect on total time to healing. [ABSTRACT FROM AUTHOR]

Aim: To investigate the influence of compression bandages, manufactured using materials with different elastic properties, on the impaired venous pumping function in patients with venous insufficiency. Methods: Ejection volume (EV) and ejection fraction (EF) were measured using strain gauge plethysmography distal from the patella without and with elastic and inelastic compression bandages in a total of 30 patients with major venous reflux in the great saphenous vein. The interface pressure of the bandages was measured simultaneously in the medial gaiter area. Normal values of EV and EF were obtained from 15 healthy controls. Results: Patients with venous insufficiency showed a statistically significant reduction of EV and EF compared to controls. Elastic bandages with an average pressure of 42mmHg in the supine position achieved a moderate increase of EV and a significant improvement of EF (p < .01), while inelastic bandages applied with comparable resting pressure (41mmHg) raised EV and EF into a normal range (p < .001). The improvement of the ejection fraction correlates well with the pressure differences between standing and lying (Static Stiffness Index) and between muscle systole and diastole during exercise (Pearson r = 0.69 and 0.74 respectively, p < .001). Elastic bandages applied with high stretch in order to achieve standing pressures comparable to those of inelastic bandages (>60mmHg) led only to a minor improvement of the venous pumping function. Conclusions: Ejected volume and ejection fraction, which are severely reduced in venous insufficiency, can be increased by compression therapy. Inelastic compression is much more effective than elastic bandages, and is able to normalize venous pumping function. With elastic bandages EV and EF always remain below the normal range even when applied with high stretch producing a resting pressure that is barely tolerable. [ABSTRACT FROM AUTHOR]

Objectives: Venous leg ulcers represent a major clinical problem, with poor rates of healing. Ideal treatment is compression bandaging. The effect of compression on neurovascular tissues involved in wound repair is unclear. This study aims to assess the effect of four-layer compression therapy (40 mmHg) on neurovascular function and wound healing in people with chronic venous leg ulcers – 15 people (55 years or older) with venous leg ulcers for more than six weeks. Methods: Basal microvascular perfusion measurement (MPM), oxygen tension (tcpO2) measured at sensor temperatures of 39°C and 44°C and sensory nerve function using electrical cutaneous perception thresholds (ECPT) at 5, 250 and 2000 Hz (corresponding to C, Aδ and Aβ fibres) were assessed adjacent to the ulcer site, and at a mirror location on the non-ulcerated limb. Testing was undertaken before and after therapy for 5–12 weeks of four-layer compression bandaging. Results: There was significant improvement in tcpO2 at 44°C and ECPT at 2000 Hz (P<0.05) compared with pre-intervention. Changes in basal MPM, tcpO2 at 39°C and ECPT at 5 and 250 Hz after compression therapy did not reach statistical significance. Conclusion: Four-layer compression bandaging in people with venous leg ulcers improved some components of neurovascularture in people with chronic venous leg ulcers. Whether this improvement has contributed to wound healing in this study requires further investigation. [ABSTRACT FROM AUTHOR]

Lymphorrhoea, the weeping of lymph through the skin, is a complication of chronic oedemas, and is generally poorly known or understood by the majority of nurses and doctors. It can occur not just in the legs, but also in other parts of the body affected by lymphoedema such as arms and axilla, chest and genitals. Using a case study to illustrate the key messages, this article discusses the management of lymphorrhoea and highlights the need for all health professionals to be more aware of this unpleasant and disruptive condition. [ABSTRACT FROM AUTHOR]