Bergan J.J.Sparks S.Angle N.
A Comparsion of Comprssion Pumps in the Treatment of Lymphedema
Vascular Surgery Vol.32; 9/19 1998 Nr.5, 455-62

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From the Department of Surgery,University of California,San Diego,California.

Purpose:This study was done in order to ascertain wich methods of mechanical
compression would be optimum in treating patients with
primary and secondary lymphedema.
Material and Methods:Thirty-vive patients(26 womwn,9men)were enrolled in the
study.The women ranged in age from 36 to 82 years (mean 56,9
years).the men ranged in age from 31 to 83 years (mean 56.4
years).Ultimately,32 patients completed the study.Each patient was treated
by random assignment to each of the tree types of compression
pumps.The treatment arms were as follows(1) unicompartmental
nongradient pump with pressure of 50 mmHg,(2)a
three-compartement pump with segmental, nongradient pressures of 50 mmHg in
each of three cells, and (3) a multicompartmental gradient pressure
pump with then cells ranging in pressure from 80 at the most
distal to 30 at the most proximal.There were 35 extremities treated
by each of the three methods.Eleven had primary lymphedema and
34 had secondary lymphedema.
Results: The mean percentage volume change was +0.4% in the limbs treated
with the unicompartmental pump,*7,3 % in the three-compartment
pump,and 32,6% in the ten-compartment pump.By use of
Kursal and Wallis,one-wayANOVA on ranks,a significant difference
between the three treatmants was detected (p<0.001).in treatment of primary
lymphedema there was no diffrerence between the subgroups with
regard to the effect of the three compression treatment of
secondary lymphedema,there was non reduction in the size of the limbs
treated with the single-compartment,there was a-4.65% reduction
in the three-compartment pump treatment,and -28.4% in the ten
compartment pump.There were no differnces in treatment of secondary
limbs with and without radiation.In an analysis comparing
primary to secondary lymphedema with and without radiation,the resuts were
not statisticlally different from one another.Other factors such as
severity of lymphedema,gender,duration of lymphedema,history of
infection,and presence of radiation could not be implicated as having
prognostic significance or having any effect on response to therapy.
Conclusions:Mechanical external pneumatic compression can produce a
reduction in treated linb volumes in primary and secondary lymphedema.
This is best achieved by multicompartment sequential compression.Limb
volume reduction by single-or three-compartment devices
is decidedly less effective in treatment of lymphedema.