Theis S, Deltombe T,Jamart J, Schoevaerdts J-C, Buche M
A 30 or 90 mmhg - manual or pneumatic - drainage in primary limb lymphoedema: a comparative plethysmographic study
The european journal of lymphology- Vol.XII;Nr.41 Sp.Co 1.2004-3

Purpose: Volumetric effect of a 30 or a 90 mmHg external pressure has been evaluated in primary lower limb lymphoedema (PLLL).

Methods: Starting at the root of the limb, a retrograde drainage is carried out manually with a light manual lymph drainage (MLD) and pneumatically with a 7 chamber boot of a programmable sequential pump (QIM 914,2). The pneumatic retrograde drainage (PRD) (program 50) was used twice: once with 30 mmHg, once with 90 mmHg. The 16 min session of those 3 procedures were spaced in time by 15 min rest. The order of execution offered 6 possibilities and was permuted after each case. Relative volume changes (%∂V) of the calf were recorded continuously (108 min) with a Hg plethysmograph (SeriMed PL2) gauge fitted 10 cm below the knee. At present, 8 consecutive woman (34-years old) with massive (49 cm of calf circumference) and old (18 years) PLLL (at birth: 2, praecox: 5, tarda: 1) completed the study.

Results: Ehatever the pressure or technique, all PLLL experienced a progressive calf decongestion. Volumetic calf decrease reaches 0,07%∂V/min manually, 0,06%∂V/min by means of a 30 mmHg PRD and 0,15%∂V/min by means of a 90 mmHg PRD. With 30 mmHg, there was no difference between manual and pneumatic techniques. With 90 mmHg, decrease is noticeably higher (p<0,001). After stopping management, improvement mainly persisted with respectively a slow reappearance of 0.01%∂V/min; 0,01%∂V/min., 0,05%∂V/min.

Conclusions: Promoting greater decongestion, a 90mmHg pressure may offer additional benefit for women with old PLLL.