Lymphedema Clinical Trial
Official title:
Randomised Controlled Trial to Compare the Influence of Sub-bandage Pressure on Percentage Volume Reduction of Leg Lymphoedema
Although there is no doubt about the need for compression therapy in lymphoedema, it is not investigated in much detail how much pressure is needed to get optimum volume reduction. New research suggests that there is obviously an upper pressure limit beyond further increase of pressure seems contra productive. This upper limit is around 30-40 mm Hg of initial pressure exerted by inelastic bandages on the upper and around 50-60 mm Hg on the lower extremity. This study is designed to investigate the effect of pressure on %volume reduction of leg lymphoedema with 2 bandages which are very comparable in product properties (slippage, stiffness, etc.), but differ in their pressure exerted to the limb.
Lymphoedema is a chronic swelling caused by the regional accumulation of protein-rich fluid
in tissues due to a compromised lymphatic system. This may present as primary lymphoedema,
defined as congenital abnormality of lymphatic vessels or secondary lymphoedema, acquired
from various insults to the lymphatic system, such as malignancy, trauma, surgery or
irradiation. It is most frequently seen after lymph node dissection, surgery or radiation
therapy during cancer treatment, most notably breast cancer. In the United Kingdom a large
prevalence study was undertaken by Moffatt et al and a rate of 1.33 per 1000 population was
identified. In general, the prevalence increases with age and is higher in women than in
men. One function of the lymphatic system is to remove fluid from the interstitial tissues
and return it to the venous circulation. compression therapy is the cornerstone in the
treatment of lymphoedema
Much of evidence how compression works is based on research in venous disease, which has
been extrapolated to lymphoedema. Hence, compression bandaging systems available in the
market are used for the treatment of venous disease and at the same time lymphoedema.
This upper limit is around 30-40 mm Hg of initial pressure exerted by inelastic bandages on
the upper and around 50-60 mm Hg on the lower extremity. This is also stated in the
International Lymphoedema Framework position document "Compression Therapy: A position
document on compression bandaging".
100 subjects with leg lymphoedema will be enrolled into the study. The duration of study
will be one week for each participant. All participants will receive compression therapy
with 3M Coban 2 and 3M Coban 2 Lite respectively according to the randomisation list. The
goal of the present study is to gain information on %volume reduction of lymphoedematous
legs in relation to pressure.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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