Long-term results of compression treatment for lymphedema

PUBLICATION: C.J. Pappas, MD, and T.F. O’Donnell Jr., MD, FACS. (1992) Journal of Vascular Surgery, 16, 555-564.

STUDY SIZE: 49 patients

The long-term courses of 49 patients managed by one surgeon were reviewed to assess the long-term effects of a program entailing (1) sequential external pneumatic compression (SEP), (2) elastic compression stockings to maintain the post-SEP girth, and (3) daily skin care. Limb girths measured at nine levels on the limb were obtained serially in follow-up visits (mean: 25 months) by an independent observer to provide an objective response to therapy. The relative reduction was determined by the difference between the pretreatment, post-acute treatment, and long-term treatment girths. In long-term follow-up, 26 of the patients maintained a full response (reduction at >3 levels), whereas  

10 maintained a partial response (reduction at <=3 levels). At late follow-up, calf and ankle girths were reduced by an absolute value of 5.37 +- 1.01, and 4.63 +- 0.88 cm in the full-response group and 5.43 +- 1.58 and 3.98 +- 1.18 cm in the partial response group over pretreatment measurements. The degree of subcutaneous fibrosis in relationship to the duration of the edema appeared to influence results greatly. The treatment of lymphedema with SEP and compression stockings is associated with long-term maintenance of reduced limb girth in 90% of patients.