Compression therapy is commonly used with moderate to severe lymphoedema. In the active phase of treatment and periodically in the maintenance phase multilayer bandaging is implemented. It is especially used when a large volume reduction is required or to soften fibrotic oedema. It also has increasing use prior to new garments as there is an opportunity for greater reduction. Most times it’s carried out by the lymphoedema practitioner but for many reasons self- bandaging may be implemented.
There are a variety of bandage systems including traditional multilayer bandaging, two layer systems and compression wraps or a combination of these.
Research in self-bandaging is limited. In 2014 Dorit, Tidhar, Pamela Hodgson, Carol Shay and Anna Towers published a paper in Physiotherapy Canada titled:
A Lymphedema Self-Management Programme: Report on 30 Cases
Patients attended a self-bandaging clinic with multilayer bandaging. The program included an intensive course of self-bandaging for a period of between 3 -12 weeks. These clients re-bandaged themselves each day and were assessed weekly by their lymphoedema practitioner who monitored volume, pain and range of movement.
Reductions of 48 – 92% and reported global rate of change > 80% for 75% of participants was achieved. It assisted selected patients with independence and self-efficacy.
At the 2014 International Lymphoedema Framework conference in Glasgow a poster by Debbie O’Halloran explored the topic of Empowering the Lymphoedema Patient to Apply Compression Bandaging. Mrs K a 73 year old with primary lymphoedema in the left leg including a lobule at her knee was unable to wear compression stockings due to lack of strength to apply them. A solution was to wear a compression sock and toe caps and then Coban 2 bandage above to the groin. She did this twice weekly and over a period of 18 months excess measurements went from 144% to 66%. Once this stabilised she only needed to self-bandage 1-2 times per week. The result has also meant that she is more mobile and in control of her lymphoedema.