Controlling lymphoedema with compression garments

 

 

Sleeves can be used for swollen arms and stockings for swollen legs. Compression garments are also available for lymphoedema affecting the breast/chest and genital area.

They work by:

• compressing the swollen tissues and stopping fluid from building up
• helping to move fluid to an area that’s draining well
• providing support, which allows the muscles to pump fluid away more effectively
• applying more pressure in certain areas to encourage the fluid to drain.

Having a compression garment fitted Back to top

It’s important to be fitted by someone experienced in selecting, measuring and fitting compression garments. Your lymphoedema specialist will usually do or arrange this for you. Compression garments are available in different grades of pressure depending on the degree of lymphoedema you have. 

In many hospitals, compression garments are available from the breast care nurse or surgical appliances department.

They come in a range of shades to match different skin tones and hypo-allergenic types are available for people with sensitive skin. Some garments are available ‘off the shelf’, or you may need to have them made to measure. Your GP can prescribe garments but usually only on the recommendation of your lymphoedema specialist. Your specialist will measure you and let your GP know the most appropriate type and correct size for you.

Putting on and removing compression garments Back to top

During your fitting you should also be advised and shown how to put on and remove the garment. Here are some useful suggestions:

Wearing compression garments Back to top

It’s important to wear your compression garment all day, but it can usually be taken off at night when you’re lying down and resting. If you’re travelling a long distance, especially by air, make sure you wear it for the full length of the journey and for some hours afterwards. You should be given at least two garments so that you can have one in the wash while you wear the other. The manufacturer will supply washing instructions. Worn every other day, they usually last between 4–6 months.

If your compression garment is too loose, it won’t control swelling and needs to be refitted. If it’s too tight, it will restrict blood flow. If you get pins and needles, pain, or your fingers or toes change colour, it’s too tight. Remove it straight away and contact your lymphoedema specialist for advice. It’s important that you’re properly measured and fitted to prevent these problems from happening.

When not to use compression garments Back to top

There are some situations when compression garments shouldn’t be worn. You should avoid wearing one if:

• you have an infection (cellulitis)
• the arm or leg is large and irregular in shape
• the skin is fragile or damaged
• the skin is pitted, folded or leaking lymph fluid.

Compression garments used incorrectly can be harmful, and won’t help the swelling go down. The material can form tight bands across the skin and even damage it. If you’re in doubt, ask your lymphoedema specialist for advice.

If the limb is large and irregular in shape, compression bandaging (see below) is used first to reduce it before a compression garment is fitted.

Compression bandages Back to top

If your arm or leg is very swollen or misshapen it may be difficult to fit a compression sleeve or stocking. Special, multi-layer lymphoedema bandages can be used as the first part of your treatment.

A lymphoedema specialist will usually put the compression bandages on for you every day. It may take two or three weeks of bandaging before it’s possible to fit a compression sleeve or stocking.

Bandaging is often combined with manual lymphatic drainage (MLD) massage| or simple lymphatic drainage (SLD) massage|, exercises| and skin care| to reduce the size of a limb that’s very swollen.