Following your assessment, at the clinic, you may have been advised you need a course of lymphoedema compression bandaging.
This may be because the shape or the size of your limb is not yet suitable for a compression garment, or your skin may not be in a good enough condition.
You may have a wound or leg ulcer that would heal faster with bandaging treatment. It may be you are having a top up of previous intensive treatment. Before commencing any bandaging we will have carried out a simple investigation of your arterial assessment, on your legs. This is to check it is safe to apply compression to your limb.
Also, we may need to write (with your permission) to your GP and/or hospital consultant. This is to ensure there are no contra-indications to treatment related to your medical history.
At LymphCare UK we use two different types of bandage systems and on assessment, your Lymphoedema Nurse Specialist will advise which is most appropriate for you.
The usual length of treatment is 2 to 4 weeks, however, if your situation is complex it may take longer.
You will be required to attend clinic between 2 and 5 times a week according to which bandage system we are using.
This will be done in your own home if you are housebound. You should keep your bandages on over the weekend. We take into consideration your personal circumstances and try as much as possible to meet your individual needs.
We also work with District Nurses and Practice Nurses to carry out treatment in the most appropriate place for you.
We may measure your limb before and after your course of treatment in order to monitor your progress. At each session we will discuss anything you have been experiencing during your treatment and then remove your bandages and examine your limb, we can review how well your bandages are working and make any adjustments required. Your arm or leg will be washed and dried well.
If you are also having other intensive treatments at the same time as your bandaging such as Medical Lymphatic Drainage, or intermittent pneumatic compression therapy, these treatments will be carried out at this point. We will then moisturise your limb, apply any dressings if necessary and reapply your bandages.
During your treatment, we will be discussing and planning what compression garment you will require following your bandaging. This will then need to be worn on a daily basis. We may also advise you to wear this at night for a period of 4 to 6 weeks after your bandaging, this will be advised on an individual basis.
Your bandage should feel firm but not uncomfortable or painful. Therefore, if you experience any of the following remove your bandages immediately.
- Pain
- Shortness of Breath
- Chest pain
- Discolouration of toes
- Numbness of toes
Inform us of this as soon as possible during clinic hours. If required, and if you are housebound, we will make sure you have access to emergency District Nurses to assist you with removing the bandaging. Top Tips
- Driving: this can be an issue if you are having compression bandage therapy as part of your plan of care. Compression bandaging can be bulky and can affect what footwear or clothing you wear and may restrict your movement. Always check with your car insurance company that you are still covered to drive whilst in bandaging. It may be advisable to make alternative arrangements for a relative to take you to the clinic. Be responsible and safe.
- Clothing -With several layers of padding and compression bandage you may find this quite bulky and difficult to wear your normal clothing. You will need stretchy wider trousers or skirts for leg bandaging and vest tops, wider sleeved tops for arm bandaging.
- Footwear -your Lymphoedema Nurse Specialist may ask your GP to prescribe a special bandage shoe or you could try to apply your own shoes if they are large enough.
- Remember to bring any soap substitutes and moisturisers with you to the clinic.
- Remain as active as possible and carry out any specific exercises that your Lymphoedema Nurse Specialist has advised – your bandaging works much better due to the muscle movement.
- Elevate your bandaged limb when resting
- If you are having your arm bandaged plan ahead re meals and washing up-enrol help of friends and family
- Don’t forget to bring your usual footwear on the last day of treatment, it’s amazing how many people forget!
Compression garments are the most important treatment in the long term management of your lymphoedema, lipoedema or chronic oedema.
Whatever the cause of your swelling, once it has been established that compression is appropriate for you, wearing your garment on a daily basis is the most effective way of improving or maintaining your condition.
Compression garments work in several different ways.
First, the pressure of the material helps to prevent retention of fluid in the tissues. It also provides resistance for the muscles to work against, which encourages the flow of blood and lymph fluid within the lymphatic and venous systems.
Compression garments are graduated – higher strength at the foot or hand which reduces through the garment.
This helps to move fluid towards the root of your limb where it can be drained away more effectively. There are many different levels of compression, materials and style of garments.
Our Lymphoedema Nurse Specialists are experts in assessing and advising you on the most appropriate garment for you. Sometimes we may need to take some more specific measurements to then supply you with a made-to-measure garment. As much as possible your garments will be prescribed either by a Nurse Prescriber, or a prescription will be requested from your GP.
Occasionally, your garment may not be available on prescription and your garment will be provided at the clinic. It may be that your swelling is located in a part of your body other than your arm or leg, for example, your face, chest, abdomen, or genital area.
We are also able to assess and measure you for suitable garments or supports in these situations. It is usual to wear your garments during the day and remove it at night. Your
Garments last approximately 4 to 6 months depending on materials and manufacturers guarantee, always make sure your garments are in a good condition as they will be less effective when well washed and worn.
REMOVE YOUR GARMENTS IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING
- Your fingers/toes become painful, numb or discoloured
- Your garment is too tight or painful
- Your limb has become red, hot, or more swollen than usual you may have cellulitis
Wear your compression garment every day
- Put your garment on as early as possible in the morning
- Wear your garments during exercise and travel
- Always tell your Lymphoedema Nurse Specialist if you have any problems with your garments-we want to help solve any issues to make your daily wearing of garments as comfortable and effective as possible
- Always follow manufacturer’s washing instructions, your garments will last longer, you should have two garments one to wash, one to wear.
- Ask about application and removal aids, it can make all the difference
- Ask about grip tops and skin glues if you are having problems with your garment rolling down
Compression Velcro® Wrapping Systems
In some situations, Velcro® wrapping system can be a very useful as an alternative to compression bandaging or compression garments.
The wraps work in the same way as bandaging and works best when you are moving, using your muscle pump action.
The wrapping systems consist of a protective liner, over which the wrap is then applied. Velcro® stretch bands are secured around the limb and you are able to alter compression according to how much you stretch the wrap as you apply it.
Wraps consist of a foot piece, a lower leg piece, and in some systems a thigh wrap option.
Your Lymphoedema Nurse Specialist can advise you if wraps are a possible addition to your treatment. Some wrapping systems are available on prescription via one of our Nurse Prescribers or your GP.
Intermittent Pneumatic Compression Therapy (IPC) is the use of mechanical air driven pumps via inflatable garments that are used over your swollen limbs.
IPC has been available for many years in the management of chronic oedema.
IPC should only be used under the supervision of a Lymphoedema Nurse Specialist who can assess your suitability for IPC as it is not suitable for everyone.
IPC can be used as part of a combination of treatment in clinic or a standalone course of treatment.
LymphCare UK is proud to have a lending library of IPC pumps at our branches. This enables patients, after their trial treatment in clinic, to borrow a machine for a six week period. The device can then be used regularly in the comfort of your own home.
Please ask your therapist if you would like to know more about IPC.
