An Auto-Adjustable Night Garment to Control Early Rebound Effect of Edema Volume After Intensive Phase of Decongestive Lymphedema Therapy

Sandrine Mestre, Gessy Gaillard, Murielle Benhamou, Virginie Soulier-Sotto, Monira Nou, Marion Pasqualini, Cyrine Ben Amor, and Isabelle Quere. Lymphatic Research and Biology December 2017

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An Auto-Adjustable Night Garment to Control Early Rebound Effect of Edema Volume After Intensive Phase of Decongestive Lymphedema Therapy

Sandrine Mestre,  Gessy Gaillard, Murielle Benhamou, Virginie Soulier-Sotto, Monira Nou, Marion Pasqualini, Cyrine Ben Amor, and Isabelle Quere. Lymphatic Research and Biology December 2017

Background: Lymphedema of the arm and/or hand is a well-established complication of breast cancer therapy. The objective of the study was to determine the interest of auto-adjustable MOBIDERMAutofit night arm sleeve in controlling edema rebound effect in breast cancer-related lymphedema patients just after a successful intensive phase of decongestive lymphedema therapy (DLT).

Materials and Methods: This is a subgroup analysis of MARILYN Study, conducted on 40 patients after completion of intensive DLT. Patients were randomized in Night-user group (fitted with MOBIDERM Autofit device) or No night-user group (no night compression). For subgroups analysis, patients were defined as high responders (HR) if their lymphedema volume reduction during DLT was ‡35% or as low responders (LR) if it was below 35%.

Results: In HR subgroups (n=16), the mean lymphedema volume variation between Day 0 and 30 was 28.4mL in the night-user group versus 181.4mL in the no night-user group. When adjusted to the loss of volume during DLT, 89% of the DLT benefit is maintained in HR night-user versus 54% in no night-user group. Between LR (24 patients), this mean volume variation was by 65.1mL versus 54.9mL in night-user and no night-user groups respectively between Day 0 and 30.

Conclusion: Wearing MOBIDERM Autofit, on top of the day time hosiery, appears a promising way to control the early rebound effect during the maintenance phase especially in DLT-HR.

Main findings

  • Night garments are important to stop rebound oedema after intensive bandaging for lymphoedema.
  • The author states there has been no other previous study that investigates the role of night garment in the maintenance phase.
  • Small sample size with 40 female patients divided into 2 groups.
    • The Night-user group, was fitted during the first 30 days WITH MOBIDERM Autofit device (pressure of 15mmHg). This was in addition to their made to measure day-time THUASNE lymphology hosiery, a circular knitted garment. The level of compression was either 15–20mmHg (French class 2) or 20–36mmHg (French class 3) which was decided by the investigator.
    • The No night-user group only wore their made to measure day-time THUASNE lymphology hosiery during 30 days.
  • The expected rebound effect during the first month after intensive DLT phase (Day 0–30) was observed only in the no night-use group with an increased lymphedema volume by 181.39mL–198.84. In the night-user group, this effect was erased (mean lymphedema volume variation between Day 0 and 30 was 28.36mL –90.01) corresponding respectively to maintenance of 55% and 89% of the benefit of the intensive treatment phase.
  • From Day 30 and 90, after Mobiderm Autofit is introduced and applied to all patients the mean lymphedema volume variation remained stable in the initially randomized night user group (1.29mL) and tended to increase more slowly in the randomized no night-user group (92.87mL).
  • Considering the volume lost during the DLT, maintenance of this benefit at Day 90 was of 88% and 32% in high responder night user and no night-user subgroups.
  • The higher the volume reduction achieved during DLT period, the higher the risk is to have a rapid increase of the lymphedema volume just after the completion of the intensive phase of treatment.
  • MOBIDERM Autofit arm sleeve presented beneficial properties to control the rebound effect particularly when the volume mobilized during the intensive phase is high.
  • The author states that this study is the first to show an effect of the use of night time garment in the control of the rebound effect after completion of the initial intensive phase.