Complete decongestive therapy versus compression bandaging alone in advanced secondary lymphedema

Abstract

Background. Secondary lymphedema results from a known insult to the lymphatic system. Worldwide, secondary lymphedema is more common than primary lymphedema. Compression therapy is the mainstay of management for all stages of lymphedema. Purpose. To compare between the effectiveness of compression bandaging (CB) alone to the international standard treatment of (CDT) in patients with advanced secondary lymphedema. Methods. Sixty patients of both genders with lower limb secondary lymphedema (stage II and III) aged from 40 to 55 years old, with body mass index (BMI) less than 35 and duration of illness ranged from 3-9 years were included in the study. They were randomly assigned into two groups of equal numbers. Group A: Thirty patients received CDT (Manual lymph drainage, CB, exercises, and skin care). Group B: Thirty patients received MCB using short stretch bandages alone. The treatment sessions consisted of twelve sessions, three times per week for a total duration of four weeks. The assessment of limb volume was done using water displacement method and truncated cone volumetric measurements (pre-treatment and after 12 sessions (post-treatment)). Results. Within both groups, there was a significant reduction in water displacement volumetric measurements pre vs. post treatment in groups (A& B) p-value = 0.0001, p-value = 0.0001 respectively. As well, there was a significant reduction in truncated cone lower extremity volumetric measurements between pre and post treatment in groups (A & B) p-value = 0.0001, p-value = 0.028 respectively. However, there were no significant differences in the mean values of water displacement volumetric measurements and truncated cone mean volumetric values between both groups (p = 0.835, p = 0.397) respectively. Conclusion. Compression bandaging alone is as effective as complete decongestive therapy in advanced secondary lymphedema.