The Effect of Hosiery on Interstitial Fluid Pressure and Arm Volume Fluctuations in Breast Cancer Related Arm Oedema

Abstract

Objectives: (1) To measure interstitial fluid pressure under one brand of hosiery in arm lymphoedema. (2) To assess the stability of the swelling over various time scales. Setting: Human microvascular studies laboratory of a teaching hospital. Subjects: Patients with arm oedema following successful breast cancer treatment. Main outcome measures: (1) Arm volume calculations using multiple circumferential measurements by tape measure. (2) Interstitial fluid pressure measurements by wick-in-needle technique in subcutis. Results: The mean swollen arm was 33% greater in volume than the contralateral arm ( n = 50). There was no significant correlation between the size of the arm and the duration of the swelling. There was no significant change in arm volume over 2 weeks ( n = 8) but there was a small (50 ml), significant increase overnight ( p < 0.05). The mean (SD) interstitial fluid pressure while wearing one brand of hosiery (Sigvaris) was 18.7 (5.8) cmH2O compared with 1.2 (2.8) cmH2O after its removal. There was a significant correlation between the pressure under the sleeve and the pressure without the sleeve ( r = 0.68, p < 0.05). Conclusions: The Sigvaris sleeve exerts sufficient compression to underlying tissue to raise interstitial fluid pressure. This may control arm swelling by reducing fluid filtration rate and/or raising fluid drainage rate from the arm.