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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]

Abstract 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.

This article discusses a study that compared the effectiveness of silver colloid dressing to conventional dressings in treating diabetic foot ulcers (DFUs). The study found that silver colloid dressing resulted in faster healing and decreased ulcer area compared to saline dressings. The study suggests that silver colloid dressings, which release silver ions, are more effective in managing DFUs and reducing ulcer areas over time. However, more information about the study design and sample size is needed to fully evaluate the findings. [Extracted from the article]

BackgroundPeripheral nerve damage can have debilitating consequences. Rabbit sciatic nerve transection models allow the effective evaluation of surgical repair strategies for large nerve gaps. Despite advantages in size, ease of handling, and functional utility, rabbits can suffer from a number of side effects that affect animal welfare and the quality of scientific inquiry. Such side-effects, which include pressure ulcers and traumatic damage to the foot, are primarily a consequence of insensitivity of the distal hindlimb following sciatic nerve injury. In this study, we present a number of methodologies for identifying, treating, and preventing unintended adverse effects in rabbit sciatic nerve injury models.ResultsFirst, we categorize pressure ulcers according to their severity and describe the deployment of a padded bandaging technique to enable ulcer healing. We also introduce a proactive bandaging approach to reduce the likelihood of pressure ulcer formation. Second, we define phenotypes that distinguish between foot injuries resulting from self-mutilation (autotomy) from those caused by incidental traumatic injury secondary to sensori-motor damage. Finally, we detail an effective strategy to reduce the usage of Elizabethan collars; through a gradual weaning protocol, their usefulness in preventing autotomy is retained, while their propensity to impede rabbit grooming and cause abrasion-injury to the neck region is minimized.ConclusionsWe suggest that application of these methods offer a practical and systematic approach to avoid adverse side effects associated with rabbit sciatic nerve damage, enabling improved animal welfare and scientific outcomes in a powerful nerve injury model.

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: Patellofemoral pain syndrome (PPS) is defined as a condition in the patellofemoral joint that can present with pain, functional deficit, crepitus, and instability. Its etiology appears to lie in excessive loading of the patellofemoral joint due to mispositioning of the patella. The application of taping has recently increased, to manage PPS. However, the level of scientific evidence in this sense is unknown. OBJECTIVE: To determine the effect of different types of taping in subjects with PPS. METHODS: A bibliographic search was carried out in January and February 2021 in Scopus, Web of Science, PubMed, Medline, SPORTDiscus, PEDro and CINAHL. RESULTS: A total of 13 studies were included for qualitative analysis. The mean score on the PEDro scale was 5.30 points. Most of the articles reflect a decrease in pain after the taping intervention, while variables such as functionality, muscle activity and biomechanical modification do not show positive effects. CONCLUSION: Taping appears to have positive effects on pain in subjects with PPS. However, the evidence is contradictory with the rest of the variables studied. [ABSTRACT FROM AUTHOR]

Background: Secondary lymphedema mostly occurs as an aftereffect of cancer treatment, and it is estimated that 100,000–150,000 patients are affected in Japan. An estimated 3500 patients, develop lymphedema of the lower and upper extremities each year secondary to uterine and breast cancer treatment. Medical reimbursement was first instituted in April 2008 by the Ministry of Health, Labour and Welfare in Japan. Since 2008, we have developed guidelines regarding treatment options for patients with lymphedema based on scientific evidence. This is the third edition of the guidelines established by the Japanese Lymphedema Society (JLES), published in 2018. The JLES Practice Guideline-Making Committee (PGMC) developed 21 clinical questions (CQs). Methods and Results: A review of these 15 CQs was performed in accordance with the methodology for establishing clinical guidelines. The 15 recommendations for each of these CQs were developed and discussed until consensus by the PGMC was reached. Moreover, outside members who had no involvement in these guidelines evaluated the contents using the Appraisal of Guidelines for Research and Evaluation (AGREE) II reporting checklist. Conclusion: These guidelines have been produced for the adequate management of lymphedema by doctors and other medical staff on the lymphedema management team of medical institutes, including nurses, physical technicians, and occupational therapists. [ABSTRACT FROM AUTHOR]

EMERGENCY FIRST AID TRAINING FOR LAY PEOPLE AT SMA 14 MAROS, SOUTH SULAWESI. First aid for accidents is an important aspect of everyday life, be it at home, on the road, at school, or at the office, because emergency events need to be handled immediately at the scene. The principle of HELP is considered necessary for all levels of society, because it can help people or victims to receive professional medical care. First Aid can be done by either the general public or students, until professional medical help arrives to treat the victim. The methods used in this activity are lectures, question and answer discussions, and direct practice using phantoms as victims. Before carrying out the core activities, questionnaires were distributed for the pre-test and it was found that the community service participants were still in the low level of knowledge category. The conclusion is that there was a change in the level of knowledge before and after this training activity, and the enthusiasm of the participants was very high in practicing first aid for accident victims.

Abstract Background Peripheral nerve damage can have debilitating consequences. Rabbit sciatic nerve transection models allow the effective evaluation of surgical repair strategies for large nerve gaps. Despite advantages in size, ease of handling, and functional utility, rabbits can suffer from a number of side effects that affect animal welfare and the quality of scientific inquiry. Such side-effects, which include pressure ulcers and traumatic damage to the foot, are primarily a consequence of insensitivity of the distal hindlimb following sciatic nerve injury. In this study, we present a number of methodologies for identifying, treating, and preventing unintended adverse effects in rabbit sciatic nerve injury models. Results First, we categorize pressure ulcers according to their severity and describe the deployment of a padded bandaging technique to enable ulcer healing. We also introduce a proactive bandaging approach to reduce the likelihood of pressure ulcer formation. Second, we define phenotypes that distinguish between foot injuries resulting from self-mutilation (autotomy) from those caused by incidental traumatic injury secondary to sensori-motor damage. Finally, we detail an effective strategy to reduce the usage of Elizabethan collars; through a gradual weaning protocol, their usefulness in preventing autotomy is retained, while their propensity to impede rabbit grooming and cause abrasion-injury to the neck region is minimized. Conclusions We suggest that application of these methods offer a practical and systematic approach to avoid adverse side effects associated with rabbit sciatic nerve damage, enabling improved animal welfare and scientific outcomes in a powerful nerve injury model.

Background: Compression is a cornerstone modality in edema treatment. Different types of bandages are available in clinical practice. Short-stretch bandages are commonly used; however, newer technologies such as the two-component compression system are available as well. This study assesses the pressure curves and static and dynamic stiffness (Static Stiffness Index [SSI] and Dynamic Stiffness Index [DSI]) of two different two-component compression systems, Coban and CoFlex, for edema treatment. Methods and Results: For this prospective cohort study, 12 healthy volunteers were recruited. The healthy volunteers wore both two-component compression systems for 48 hours. Pressure sensors (PicoPress®; Microlab, Italy) were placed at 10 and 25 cm above the internal malleolus and 10 pressure readings were used to obtain pressure curves. The SSI and DSI were assessed. Additionally, comfort (ICC compression questionnaire) and adverse events were assessed as well. Both two-component compression systems exert a sufficient amount of sub-bandage pressure, although CoFlex exerts systematically significantly lower pressure in comparison with Coban. This difference in sub-bandage pressure remains constant over 48 hours. Both two-component compression systems are sufficiently stiff (stiffness >15 mmHg) and remain stiff over time. Conclusions: Both two-component compression systems have pressure curves that are high enough to motivate their use in the treatment of chronic edema. Additionally, both systems were found to be comfortable and have clinically effective SSI and DSI values. [ABSTRACT FROM AUTHOR]

Background and Objective: Hypotension is a common complication of cesarean section with spinal anesthesia, which can be dangerous for both mother and neonatal. The aim of this clinical trial study was to investigate the effect of using bandaging on the lower limbs in preventing of post spinal hypotension in cesarean section. Materials and Methods: This prospective clinical trial study was performed in 2019-2020 at Fatemieh Hospital in Hamadan. A total of 64 patients undergoing cesarean section with spinal anesthesia were randomly divided into two groups of with bandaging at the time of surgery and without bandaging. Demographic information, hemodynamic status in the first hour after spinal anesthesia, hypotension, nausea and vomiting, bradycardia, tachycardia, atropine levels, ephedrine consumed, was compared in both groups. The data were statistically analyzed by SPSS version 16 software and analyzed. Results: The mean age of both groups of patients was approximately 30 years (P = 0.958). Hypotension (25 vs. 78.1%), bradycardia (9.3 vs. 15.6%) and intraoperative nausea and vomiting (12.5 vs. 59.4%) in the intervention group with significantly less than the control group. The amount of ephedrine (4.1 3 3.1 vs. 20.6 13 13.2 mg) was lower in the intervention group than in the control group (P = 0.01). In the study of hemodynamic status of systolic and diastolic pressure from 2 to 6 minutes and mean arterial pressure from 2 to 10 minutes after spinal with a significant difference in the intervention group was more than the control group (P

The purpose of this systematic review was to produce a best evidence synthesis of the effects of Kinesiology Tape (KT) in the treatment of tendinopathies. An electronic search on five databases (PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, SportDiscus, and Physiotherapy Evidence Database (PEDro)) was conducted. Studies were included if (1) patients suffered from tendinopathy; (2) isolated KT was applied in at least one group; (3) comparisons between other techniques were developed; (4) outcomes based on pain, function, disability, or quality of life were analysed. Two reviewers independently extracted data and assessed methodological quality using the Physiotherapy Evidence Database (PEDro) scale. A total of 13 articles met the eligibility criteria, involving 454 participants. Nine of these studies presented upper extremity tendinopathies, and four explored lower extremity tendinopathies. Selected papers ranged from low to high quality, with an average score of 5 on the PEDro scale. According to our findings, there is limited evidence to support KT alone for the treatment of tendinopathies beyond the short-term. Due to the mixed methodological quality and the insufficient number of clinical trials, larger, long-term, high-quality studies are needed to support the theory that tendinopathies can benefit from KT applications.

Background: Ankle sprains are one of the most frequent injuries between athletes. After an ankle injury, 72% of patients will experience some degree of functional impairment (proprioception, ankle stability, and balance), which leads to changes in sporting and occupational activities. In the literature, there is no enough information about how bandaging and taping can affect the ankle sprain treatment and rehabilitation process. Method: Seventy-four healthy participants, the age range was 18–30 years old participated in this study. The participants were divided into two groups (taping, and bandaging groups). Proprioception and balance have been measured four times (before using tap, 20 min after using tap, 24 h after using tap, and after removing the tap). Results: In both groups (bandaging group and taping group), proprioception and balance significantly increased immediately after using tape and bandage, after 24 h of using tape and bandage, and after 48 h using tape and bandage when compared to the baseline measurements. There were no significant differences in proprioception and balance between groups. Conclusion: Ankle tape and bandage can significantly improve balance and proprioception in the uninjured ankle during the entire interval of their use. [ABSTRACT FROM AUTHOR]

Background: Multilayer bandaging (MLB) is often used for lymphedema treatment. Even experienced lymphedema therapists have difficulty applying bandages correctly. The aim of this study was to demonstrate upper limb MLB pressure variability applied by lymphedema therapists. Methods and Results: Twenty-four lymphedema therapists were asked to apply MLB to the healthy volunteer's upper limb. The participants consisted of 20 females and 4 males with a mean age of 43.4 (range: 24–62) years. They included licensed massage therapists, nurses, a judo therapist, an occupational therapist, and a medical doctor. Twenty therapists (83.3%) had clinical experience applying MLB. Compression pressure was measured with PicoPress at 5 cm proximal to the wrist, immediately after the application (phase 1) and after exercise (phase 2). The mean MLB pressure was 67.7 ± 5.0 mmHg in phase 1 and 55.3 ± 4.1 mmHg in phase 2, which were significantly different (p = 1.2 × 10−10). There was a weak negative correlation between how long the therapist had been practicing MLB and MLB pressure (R = 0.29). Seventeen participants (70.8%) expressed that they had a target pressure in mind when performing MLB. Among the 17 participants, there was no correlation between the target and actual pressures (R = −0.055). Only three participants (17.6%) had an actual MLB pressure within 5 mmHg of their target. Conclusions: The mean MLB pressure was 55.3 ± 4.1 mmHg, which was thought to be too high for the upper limb. Education about applying appropriate MLB pressures to the limbs is necessary. [ABSTRACT FROM AUTHOR]

Background: Compression is the most important component of complete decongestive therapy (CDT), but there is no standard best method for applying compression. The aim of this study was to evaluate the comparative efficacy of conventional multilayer short-stretch bandaging, and a velcro adjustable compression wrap with regard to volume reduction, ultrasonographic measurements, functional-status, and quality of life (QoL) in the active CDT period of patients with lower limb lymphedema. Methods and Results: The demographic and clinical variables of lower limb lymphedema patients were recorded. All patients received skin care education, manual lymphatic drainage, and supervised lyphedema exercises, and were randomly allocated to Group1 (multilayer short-stretch bandaging-Rosidal-K®) or to Group 2 (adjustable-compression-velcro-wrap-Circaid Reduction-kit®) for a duration of 3 weeks with 15 sessions. Limb volumes were assessed by perometer. Ultrasonographic measurements included subcutaneous soft tissue thickness. The functional disability and QoL were evaluated by the Lower Extremity Functional Scale and LYMQOL-Leg (Lymphedema Quality of Life Questionnaire-Leg), respectively, at baseline, after CDT, and at first-month follow-up. Thirty-six patients (10 male and 26 female) with mean age of 51.6 ± 11.7 years were included. Fourteen patients had primary and 22 patients had secondary lymphedema. The median duration of lymphedema was 68 months. Significant improvements in volumes and ultrasonographic measurments were observed in both groups at the end of therapies, and improvements sustained up to a month. Appearance, symptoms, and overall QoL-subscores were improved only in Group 2. Conclusion: In conclusion, adjustable compression velcro-wrap performed as a part of CDT can greatly reduce the volume similiar to conventional multilayer bandages, as well as improve the QoL. It can be a comfortable alternative to the conventional multilayer bandages in the active treatment phase of the CDT. [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 non-invasive approach for prosthetic rehabilitation of such difficult cases, using bandaging and progressively larger conformers is described here.

Objectives: The aim of this study was to evaluate the comparative efficacy of 3M™ Coban™ 2 layer system and conventional multi-layer short-stretch bandaging in terms of volume reduction, ultrasonographic measurements, functional status, and quality of life (QoL) in the treatment of patients with breast cancer-related lymphedema (BCRL). Patients and methods: This prospective, single-blind, randomized study included a total of 60 BCRL patients (60 females; mean age 54.9±9.6 years; range, 30 to 73 years). The patients were randomly allocated to Group 1 (n=30) and Group 2 (n=30). Both groups received complex decongestive therapy (CDT) including skin care, lymphedema exercises, and manual lymphatic drainage (MLD) combined with traditional multi-layer short-stretch bandaging five times per week for three weeks in Group 1 and with 3M™ Coban™ 2 layer system bandaging two times per week for three weeks in Group 2. Differences in volumes, excess volumes, ultrasonographic measurements, QoL, and functional assessment scores were evaluated at baseline, after three weeks of intensive treatment period, and at two months of follow-up. Functional status was evaluated by the Quick Disability of Arm Shoulder and Hand Questionnaire (Q-DASH), while the QoL was assessed using the Turkish version of Lymphedema Quality of Life Questionnaire-Arm (LYMQOL-Arm). The duration and easiness of applying bandages by physiotherapists and comfortableness of bandages according to patients and physiotherapists were also evaluated using a questionnaire. Results: The demographic and clinical properties were similar between the groups. There were significant improvements in the volumes, excess volumes, ultrasonographic measures, functional scores, and QoL scores in both groups at the end of treatment. The improvements were sustained at two months of follow-up. Conclusion: The 3M™ Coban™ 2 layer bandaging as a part of CDT twice a week for a period of three weeks can significantly reduce the volume and improve the disability and impaired QoL, similar to conventional short-stretch multi-layer bandages. In addition, treatment with this layer system enables a time-efficient, easy, and comfortable application of bandaging with increased mobility of the upper extremity. [ABSTRACT FROM AUTHOR]

This study hypothesized that the prolonged use of taping during athletic activities produces more significant increases in proprioception, balance, and vertical jump among volleyball players with CAI. A randomized controlled study. One-hundred participants with chronic ankle instability (CAI) participated in this study. Participants were distributed into 3-groups: taping group, bandaging group, and control group. Proprioception (ankle range of motion absolute error), balance(Y-balance test), and vertical jump (vertical jump tester). Three interventions were performed: ankle rigid taping, ankle bandaging, and placebo taping. The measurements were performed at baseline, immediately, 2-weeks and 2-months after support. Immediately after supports, there were non-significant differences between all groups for proprioception, balance (P <.05). There was a significant difference between banding and control groups, and taping and control groups for the vertical jump (P <.05). After 2-weeks and 2-months, there were significant differences between bandaging and control groups, and taping and control groups for proprioception, balance, and vertical jump (P <.05). There were non-significant differences between taping and bandaging groups (P <.05) during all assessments. This study indicated that ankle taping and bandaging immediately improve vertical jump only; while they improve proprioception, balance, and vertical jump after 2-weeks and 2-months. • The Ankle joint Taping and Bandaging have a long-term effect on increasing proprioception. • The Ankle joint Taping and Bandaging have a long-term effect on increasing Balance. • The Ankle joint Taping and Bandaging have a long-term and short-term effect on increasing Vertical jump distance. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review was to produce a best evidence synthesis of the effects of Kinesiology Tape (KT) in the treatment of tendinopathies. An electronic search on five databases (PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, SportDiscus, and Physiotherapy Evidence Database (PEDro)) was conducted. Studies were included if (1) patients suffered from tendinopathy; (2) isolated KT was applied in at least one group; (3) comparisons between other techniques were developed; (4) outcomes based on pain, function, disability, or quality of life were analysed. Two reviewers independently extracted data and assessed methodological quality using the Physiotherapy Evidence Database (PEDro) scale. A total of 13 articles met the eligibility criteria, involving 454 participants. Nine of these studies presented upper extremity tendinopathies, and four explored lower extremity tendinopathies. Selected papers ranged from low to high quality, with an average score of 5 on the PEDro scale. According to our findings, there is limited evidence to support KT alone for the treatment of tendinopathies beyond the short-term. Due to the mixed methodological quality and the insufficient number of clinical trials, larger, long-term, high-quality studies are needed to support the theory that tendinopathies can benefit from KT applications. [ABSTRACT FROM AUTHOR]

Pododermatitis is prevalent in falcons and is characterized by inflammation and infection of the plantar aspect of the feet, particularly at the central metatarsal pad. Suboptimal perch design and increased weight loading on the plantar skin have been proposed as major risk factors for the development of pododermatitis. Prevention and treatment are challenging, but weight load reduction on the affected area of the foot is an accepted goal of initial treatment. To date, to our knowledge no studies have compared the performance of different bandage-perch surface combinations on weight redistribution away from the central metatarsal pad. An ex vivo factorial experiment was designed using the feet from a peregrine falcon cadaver to quantify weight load reduction on the central metatarsal pad with different combinations of perch surfaces (wood, neoprene, artificial turf) and bandages (none, interdigital, silicone shoe). Feet were attached to a digital force gauge mounted on a manual test stand for compression testing. Weight loading at the central metatarsal pad was measured using a small force sensor. Perch-surface combinations in randomized order were tested at 250 g, 500 g, and 1 kg with 9 replicates per foot. At 250 g, all combinations reduced measured metatarsal pad forces, but otherwise performed similarly. As compression forces increased, differences emerged with the shoe combinations performing better overall, followed by a group including the neoprene and artificial turf-interdigital bandage combinations, and a third group including the interdigital/wood and no bandage-artificial turf. All combinations performed better than control (no bandage on wood). This study may assist veterinarians in selecting appropriate perching surface/bandage combinations when treating falcons with pododermatitis. [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]

The decongestive lymphatic therapy is recommended by the International Society of Lymphology, the International Union of Phlebology and the International Lymphoedema Framework as the conservative treatment of choice in the lymphedema patients. This method enables effective treatment even in patients with difficult and complicated lymphedema. We present a case of a young man with a massive, primary right lower limb lymphedema, effectively treated with the DLT. [ABSTRACT FROM AUTHOR]

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.

The aim of this study is to identify the lymphedema characteristics and the efficacy of complex decongestive physiotherapy (CDP) in 29 patients with malignant lymphedema. After CDP, total decreased volume of lymphedema was 306 mL, percentage of excess volume (PEV) changed from 43.4% to 22.7%, and lymphedema severity improved from severe to moderate status. The CDP efficacy-percentage reduction in excess volume (PREV) was 46.6%. The stage of lymphedema (P = .004), range of motion (P < .001), pain, heaviness, and tension scores (P < .001) were significantly improved after CDP. This shows that CDP is efficacious and useful in malignant lymphedema. [ABSTRACT FROM AUTHOR]

Cancer-related lymphedema is a progressive and chronic syndrome of abnormal swelling and multiple symptoms resulting from cancer treatment. Even with modern medical advances, lymphedema remains a major health problem affecting thousands of cancer survivors. To provide healthcare professionals with evidence-based clinical practice guidelines for lymphedema treatment and management, a systematic review was conducted to evaluate 75 selected articles from 2009-2014 by the Oncology Nursing Society Putting Evidence Into Practice lymphedema team. Findings of the systematic review support complete decongestive therapy, compression bandages, and compression garments with highest evidence for best clinical practice. Weight management, full-body exercise, information provision, prevention, and early intervention protocols are likely to be effective for clinical practice. Historic recommendations for activity restriction and avoidance of aerobic and resistive exercises that limit cancer survivors' daily lives have been challenged with more evidence. Cancer survivors may not need to restrict activities such as resistive or aerobic exercises and weightlifting with gradual exercise progression. Future research should focus on providing high-level evidence using randomized clinical trials with larger samples and studying lymphedema beyond breast cancer. [ABSTRACT FROM AUTHOR]

Background: Manufacturers' instructions of multi-component compression bandage systems inform that these products can remain up to 7 days during the therapy of venous leg ulcer. This implies that the pressure needed will be sustained during this time. Objective: The present research investigated the persistence of pressure of compression systems over 7 days. Methods: All 6 compression systems available in Germany at the time of the trial were tested on 35 volunteering persons without signs of venous leg disease. Bandaging with short-stretch bandages was included for comparison. Pressure was measured by using PicoPress®. Results: Initially, all products showed sufficient resting pressure of 40 mm Hg checked with a pressure monitor, except for one system in which the pressure fell by at least 23.8%, the maximum being 47.5% over a period of 7 days. Conclusion: The currently available compression systems are not fit to keep the required pressure. Optimized products need to be developed. © 2014 S. Karger AG, Basel [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]

Abstract: Objective: To define the pressures and gradients achieved by different bandages when applied by alternative bandaging techniques. Methods: An experienced bandager applied six bandages to the same leg of a volunteer using three application techniques. Pressure measurements were taken at the ankle, gaiter, calf and upper calf in three postures. Results: All bandages gave consistent pressures with all standard deviations falling below 7mmHg. The percentage increase in pressure from resting leg to standing was inversely related to bandage elasticity. Pressures were similar at the upper calf among the bandages for each application technique in each posture (differences <10mmHg). Small differences in pressure among the bandages (4–15mmHg) occurred at the ankle for the resting leg with a reduction in pressure between 6 and 63% at the upper calf compared to the ankle. These differences in ankle pressure were more marked on sitting (differences 15–18mmHg) and standing (differences 15–27mmHg), which resulted in substantial differences in gradients. Conclusions: Striking variations in pressures and gradients were observed between bandages of different physical properties applied using alternative application techniques. In order to achieve clinical benefits without tissue damage, it is essential that the therapist appreciates how a bandage will react with a specific application technique. [Copyright &y& Elsevier]

Wound healing is a complex process that traverses 4 main phases which overlap and are interdependent. Many patient-related factors can impede healing by disrupting the normal pathways from one phase to the next. Wound-related factors also determine the best techniques or dressings for each patient. Species differences between cats and dogs must be understood for the successful treatment of cats. New techniques such as fish skin graft application, photobiomodulation, and bioelectric dressings hold promise as an addition to our armamentarium against wounds. NPWT, hyperbaric oxygen, regenerative medicine techniques, and low-level laser therapies yield mixed results and large-scale controlled studies are needed., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2021 Elsevier Inc. All rights reserved.)

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]