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Falk Cardiovascular Research Center
Stanford University School of Medicine
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(Download
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300 Pasteur Drive
Stanford, California 94305-5406 - (650) 723 6141
Division of Cardiovascular Medicine
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Presented here are abstracts from a recently completed
study by the Stanford University Center for Lymphatic and
Venous Disorders. The study evaluates the use of Pneumatic
Sequential Compression for the treatment of postmastectomy
lymphedema.
The Stanford University Center for Lymphatic and Venous
Disorder is the foremost institution in the country studying
the treatment of lymphedema. Bio Compression pumps were used
exclusively in this study.
AN EVALUATION OF ADJUNCTIVE INTERMITTENT PNEUMATIC COMPRESSION
IN THE ACUTE TREATMENT OF POSTMASTECTOMY LYMPHEDEMA
A. Szuba, R. Ashalu, SG Rockson
Stanford Center for Lymphatic and Venous Disorders,
Stanford University School of Medicine, Stanford, CA USA
Srockson@cvmed.stanford.edu
We investigated the safety and efficacy of adjunctive intermittent
pneumatic compression (IPC) for the acute decongestive therapy
of post-mastectomy lymphedema. Twenty-three patients were
randomized to decongestive lymphatic therapy (DLT) with (Group
II) or without (Group I) IPC. DLT included manual lymphatic
drainage, bandaging, and exercise, performed daily. In Group
II, 30 minutes of IPC was performed daily at 40-50 mm Hg.
Arm volume was assessed by tank volumetry.
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In Group I, the 11 patients achieved 26% acute arm
volume reduction; in Group II, the 12 patients achieved a
mean volume reduction of 45.3% (p,<0.05). There were no
complications attributable to either DLT or IPC.
Conclusion:, IPC is generally safe and well-tolerated and
appears to provide synergistic benefit when used with DLT
in the acute decompressive approach to post–mastectomy
lymphedema.
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EVALUATION OF INTERMITTENT PNEUMATIC COMPRESSION AS ADJUNCTIVE
MAINTENANCE THERAPY IN POSTMASTECTORMY LYMPHEDEMA
A. Szuba, R. Achalu, S.G. Rockson
Stanford Center for Lymphatic and Venous Disorders,
Stanford Univerity School of Medicine, Stanford, CA USA
Srockson@cvmed.stanford.edu
We studied the safety and efficacy of intermittent pneumatic
compression therapy as an adjunct to standard decongestive
lymphatic therapy in patients with stable post-mastectomy
arm lymphedema.
Study design: Randomized, cross-over, 2 month study with 6
month follow-up
Patients and methods: 29 patients with postmastectomy arm
lymphedema and without evidence of active cancer were enrolled.
Patients were randomized into two groups.
Patients assigned to Group I were asked to continue their
routine maintenance therapy with use of a Class II compression
garment and self–applied manual lymphatic drainage (MLD);
patients assigned to Group II were asked to use the intermittent
pneumatic compression (IPC) pump for 1 hour daily (40-50mmHg)
in addition to conventional therapy (garments + MLD). All
patients crossed over to the alternate therapy after one month.
Patients who elected to continue chronic use of the pump were
evaluated after 6 months. Clinical evaluation was performed
at the beginning of the study, after the first and the second
month and after six month follow-up. The evaluation included
tank volumetry, skin tonometry, and measurement of range of
motion.
Results: 27 patients completed the study. Two patients voluntarily
withdrew.
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There was a mean volume reduction of
89.5 ml during the month with IPC and volume increase of 32.7
ml during the month of routine maintenance therapy.
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The difference was statistically significant (p<0.05). There
was no difference in tonometry results. Of the 21 patients who
completed chronic use of IPC, 19 were available for analysis.
After 6 months, there was a further average volume reduction
of 29.1 ml (not statistically significant). No adverse effects
of IPC were observed.
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Conclusion: Intermittent pneumatic compression is safe
and well tolerated and may offer additional benefit for patients
with postmastectomy lymphedema.
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Stimulation
of lymphatic flow by sequential pneumatic compression
Zelikovski
A., Lymphology 1980
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Pneumatic
compression in postmastectomy lymphedema -
maintenance study results
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Pneumatic
compression in postmastectomy lymphedema -
Acute TX results
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