Compression and Bandaging Information

Types of Compression – Different Standards

Several standards for medical compression stockings exist. Prescribers need to be aware of variance in standards order to treat the patient appropriately for their condition. The most recognised standards are 1-4:

- Germany and others : RAL-GZG standard

- France : AFNOR

- Great Britain : BSI

 

CHHC are experience with a wide range of high quality compression garment manufactures and with extensive variety of styles, so we can help you to find the right garment that is perfect for you.  We take great care to expertly take measurements for the perfect fit and then select garments for each individual. We work closely with your chosen prescription service and GP to ensure the correct garments are ordered and delivered.   Naturally this take may time to get right, but we will help and support you throughout the process and monitor changes on a regular basis. We are proud of our patient care and go the extra mile to make sure your happy with your garments.

The variety of compression garment and the type of material depends on serval diagnostic factors such as stage and severity to accommodate a wide range of patients with Lymphoedema or Lipodema, post-operative and post-trauma odema. Fabrics generally come in Flat Knit or Circular Knit; some garments are “Off the shelf” others are “Custom Made”, many available in various colours and patterns to increase your confidence and compliance.  Self adjustable compression wraps can be used for palliative or less abled patients, and are similar to short-stretch bandages.

 

Multi Layer Lymphatic Bandaging (MLLB) is often recommended initially to reduce swelling where a patient has severe Lymphoedema 5. It forms part of the intensive Complete Decongestive Treatment (CDT) which usually includes a combination of skin care, exercise, MLD and MLLB 5-6. Currently there are no international or European accepted standards relating to the performance of compression bandages 7 .

The concept of multi-layer lymphatic bandaging is that pressure is applied in layers, giving an accumulation of pressure. There are a variety of multi-layer bandaging systems available and include either elastic or inelastic compression bandages, cohesive/adhesive bandages, crepe bandages and/or padding layers 8.

It is rarely used as part of long-term management, only in exceptionally complex patients who cannot wear compression hosiery.

Short stretch is rating on elasticity/extensibility of a bandage to increase in length in response to an applied force 9.  Examples of short-stretch bandages include Actiban and Actico, and Comprilan. Short stretch bandages elastic bandage provides sustained compression on the lymphedema limb with minor variations during functional activity.

Alternatively, 3M Coban 2 and Coban 2 Lite Compression Systems may offer patients mobility during intensive treatment, provided patients do not show signs of allergic reaction.  Inelastic, cohesive and adhesive bandages offers rigidity and enhances the calf muscle pump function against the resistance of the bandage to reduce limb volume.

Inelastic bandages produce a low resting pressure and high pressure on moving (i.e. create peak pressures) cohesive and adhesive can be used to prevent slippage and increase bandage wearing time. Compression remains the most important treatment measure in managing Lymphoedema10.

References:

1          Franks, P.J., Moffatt, C.J., Murray, S., Reddick, M., Tilley, A. and Schreiber, A., 2013. Evaluation of the performance of a new compression system in patients with lymphoedema. International wound journal10(2), pp.203-209.

2             Takanishi, Y., Ogawa, Y., Hamada, Y. and Harris, R., 2018. The hybrid approach to treating severe lower-extremity lymphoedema. Journal of Lymphoedema13(1).

3             Mosti, G. and Cavezzi, A., 2019. Compression therapy in lymphedema: Between past and recent scientific data. Phlebology, p.0268355518824524.

4             Woods E (2008) Lymphoedema Care: The Role of Compression Therapy. Blackwell Publishing: Oxford

5             Cancer Research UK (2019). Compression treatments for lymphoedema. [Online] [Accessed 030120] Available from:  https://www.cancerresearchuk.org/about-cancer/coping/physically/lymphoedema-and-cancer/treating/compression

6            St Georges - Centre of Excellence UK (2020). Lymphoedema Department [Online] [Accessed 14/07/2015] Available from:https://www.stgeorges.nhs.uk/service/lymphoedema/

7             Moffatt CJ, Franks PJ, and Hardy D (2011). A preliminary randomized controlled study to determine the application frequency of a new lymphoedema bandaging system. British Journal of Dermatology . Nov 7. doi: 10.1111/j.1365- 2133.2011.10731

8             Lamprou DA, Damstra RJ, and Partsch H (2011). Prospective randomized controlled trial comparing a new two-component compression system with inelastic multicomponent compression bandages in the treatment of leg lymphedema. Dermatol Surgery 37, 7: (985-981)

9            Damstra R and Partsch H (2012). Prospective, Randomized Controlled Trial Comparing the Effectiveness of adjustable compression Velcro-wraps versus Inelastic Multilayer Compression Bandages in the initial Treatment of Leg Lymphedema. J Vascular Surgery

10          Gordon, K. and Mortimer, P.S., 2018. Decongestive lymphatic therapy. In Lymphedema (pp. 413-429). Springer, Cham.