What advice to give to a patient after a pneumatic compression therapy session for lymphedema?

From the Guidelines

After a pneumatic compression therapy session for lymphedema, patients should prioritize maintaining proper hydration, wearing compression garments as prescribed, elevating the affected limb, and performing gentle exercises to promote lymphatic flow, as these measures are crucial for maximizing the benefits of the therapy and managing lymphedema effectively. When considering the management of lymphedema, it's essential to look at the most recent and highest quality evidence available. According to the study published in the Journal of Clinical Oncology in 2018 1, low-level laser therapy, manual lymphatic drainage, and compression bandaging can be considered for improving lymphedema, with a Grade C recommendation. This suggests that while the evidence may not be as strong as desired, these therapies, including compression bandaging which is related to pneumatic compression therapy, have a place in the management of lymphedema.

Some key points to advise the patient include:

• Maintaining proper hydration by drinking plenty of water to help flush toxins released during treatment
• Continuing to wear compression garments as prescribed by the healthcare provider to maintain the benefits of the therapy and prevent fluid reaccumulation
• Elevating the affected limb when possible, especially during rest or sleep, to assist with lymphatic drainage
• Performing any recommended self-massage or simple exercises that promote lymphatic flow
• Monitoring the affected area for any unusual changes such as increased swelling, redness, pain, or skin changes, and reporting these to the healthcare provider promptly
• Avoiding tight clothing, jewelry, or activities that might constrict the affected area
• Following the complete treatment plan, including scheduled follow-up appointments and any additional therapies

These recommendations are based on the principle of supporting continued lymphatic drainage, preventing fluid buildup, and maintaining the improvements achieved during the pneumatic compression therapy session. While the specific study on pneumatic compression therapy itself may not be directly cited here, the principles of lymphedema management outlined in the studies 1 provide a foundation for post-treatment advice that prioritizes morbidity, mortality, and quality of life.

From the Research

Advice After Pneumatic Compression Therapy Session for Lymphedema

To advise a patient after a pneumatic compression therapy session for lymphedema, consider the following points:

• The patient should be informed about the importance of continuing their treatment plan, which may include wearing compression garments and attending follow-up appointments 2.
• It is essential to educate the patient on how to properly care for their affected limb, including keeping it clean and dry, avoiding tight clothing, and elevating the limb above the level of the heart to reduce swelling 2.
• Patients should be advised to monitor their symptoms and report any changes or concerns to their healthcare provider, such as increased swelling, pain, or redness 2.
• The use of intermittent pneumatic compression (IPC) therapy has been shown to improve quality of life in patients with lower-extremity lymphedema, and patients should be informed about the potential benefits of this treatment 2, 3.
• Patients with heart failure should be aware that manual lymphatic drainage (MLD) is a safe and effective treatment option for lower limb lymphedema, and that IPC therapy may also be used with caution 4, 5.

Follow-Up Care

After a pneumatic compression therapy session, patients should:

• Schedule follow-up appointments with their healthcare provider to monitor their condition and adjust their treatment plan as needed 5, 2.
• Continue to wear compression garments as prescribed to help maintain the reduction in swelling achieved through IPC therapy 5, 2.
• Keep a record of their symptoms and any changes they notice, which can help their healthcare provider adjust their treatment plan and provide better care 2.

Potential Contraindications

Certain patients may need to avoid or use caution with pneumatic compression therapy, including:

• Those with heart failure, who should use IPC therapy with caution and under the guidance of a healthcare provider 4.
• Patients with acute inflammatory symptoms, venous thrombosis, profuse varicose veins, diabetes, and cardiac insufficiency with edema, who may need to avoid IPC therapy or use alternative treatments 6.