![]() ![]() Although MLD is indicated as a component, current research does not support edema reduction with MLD alone however there is strong evidence that compression bandaging alone reduces edema.Ĭonsequently, many patients are not receiving appropriate treatment for their lymphedema and untreated or unmanaged ultimately costs the health care system more due to side effects that require repeated intervention. Complete Decongestive Therapy includes many components of care such as manual lymph drainage (MLD), compression (bandaging/garments), meticulous skin care, exercise and instructions in self care. Some provinces cover costs related to either compression garments or treatment, while others provide no coverage and therefore patients seek out a lymphedema therapist in private practice. Many inconsistencies exist in lymphedema management across Canada. Garment have a tourniquet effect which will cause more swelling below the level of the tight area.ĬOBAN 2 LAYER SYSTEM: CHANGING PRACTICE, CHANGING LIVES If the limb is symmetrically larger all over, the person may be able to fit into a ready made “off the shelf” garment. Since the greatest compression needs to be at the distal end (lower arm or leg) of the limb if the garment fits the top of the limb and is loose at the bottom this may cause the fluid to travel down to the hand or foot. Off-the Shelf/pre-madeĬustom fitted garments are made for limbs that have an unusual shape such as the top of the limb is much larger than the bottom, or the limb does not fit into the manufacturer sizing charts. Flat knit garments are more dense but provide a more precise fit, but because of their construction when stretched over a limb there are more holes for the skin to breathe.Ĭustom measure vs. Circular knit fabrics are less expensive and cosmetically more attractive because they do not have a seam and can be produced using finer and sheerer materials. Higher levels of pressure (>50mmHg) can only be achieved with flat knit garments. Most ready made garments are circular knit and flat knit are generally custom made. 50-60 mmHg (class IV) – prescription required for severe lymphedema of lower extremity.40-50 mmHg (class III) – prescription required for severe lymphedema especially of lower extremity.30-40 mmHg (class II) – prescription required for moderate lymphedema in upper or lower extremity.20-30 mmHg (class I) – prescription required for mild lymphedema in upper or lower extremity.15-20mm Hg – no prescription required preventative for tired achy legs good for mild swelling experienced on airplane flights.The “ grades” for compression are measured in mmHg (millimeters of mercury just like the pressure of a blood pressure cuff): Please consult with your lymphedema therapist, doctor and fitter to find the best one for your unique needs. Therapeutic benefit is lost if the garment is stored away. There is a wide array of compression garments to choose from and deciding which one is suitable can be daunting. Having the right fit is the most important aspect - compression garments are effective only if they are worn consistently and the patient is satisfied.
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