Abstract

Use of Haddenham Venex armsleeve for lymphoedema management in clinical practice

Jeanne Everett, Sue Lawrance . Bristish Journal of Community Nursing. October 2019

Lymphoedema of the upper limb can be an unwelcome side effect of treatment for breast cancer, some skin cancers, as well as having noncancer-related causes. Treatment focuses on patient self-management, and involves skin care, exercise, lymphatic drainage massage and compression. Lymphoedema is a chronic, life-long condition, and the correct choice of garment will influence treatment outcomes, enhancing concordance and improving quality of life. This article examines how, following recent improvements to the comfort and overall fit of the Haddenham Venex lymphoedema sleeve, patient feedback informed the implementation of further modifications, and how gaining feedback from patients has empowered them to manage and monitor their own condition. By taking ownership for their own care, long-term control of the condition is improved and self-management is enhanced.

Main findings

• To improve the comfort and overall fit of the sleeve, several modifications have recently been implemented. These include adding a comfort zone to the elbow area to improve overall convenience when moving and modifications to the mitten to ensure a comfortable fit while maintaining the correct level of compression over the hand (Figures 1 and 2). Further modifications were made to the sizing of the sleeve, once again, to ensure a better fit, with a slight change to the measurement points used.
• To measure the effectiveness of the changes to the Haddenham Venex sleeve, a questionnaire was developed and completed by patients who had agreed to trial the new sleeve. Each patient was measured and fitted with the appropriate Haddenham Venex sleeve and asked to provide their feedback after 2 weeks of wearing. A total of 12 questions were posed to ascertain how the patients found donning and doffing, as well as the overall fit and comfort of the sleeve, particularly in relation to the changes to the hand piece. There was an extra box for further comments.
• N = 20
• Donning/doffing: ‘Soft fabric, I found it easy to get the sleeve on and off’. ‘This sleeve was easier to put on than previous sleeves I have tried’.
• Overall fit: ‘Better fit and felt more supportive’. ‘This sleeve was a wonderful fit’. In response to patient feedback during the trial, further adaptations were made at the top of the sleeve. Grip top options: ‘I like the wider grip top and options of the lace and non ‘bobbly’ silicone’. ‘The grip top fitted well compared with other sleeves used before’. ‘I especially liked the grip top, both the stickiness which stayed up well, and the width of the grip top—because it was wider it did not roll down as with previous sleeves’. ‘Liked the lace top—more feminine’.
• Comfort: ‘The sleeves are a comfortable fit, snug, but not restrictive’
• Elbow: ‘the elbow insert makes this more flexible
• Hand: ‘I found the hand section to be supportive and comfortable with no rubbing in the thumb area’.