Manjula Y, Kate V, Ananthakrishnan N.
Evaluation of sequential intermittent pneumatic compression for filarial lymphoedema.
Natl Med J India. 2002 Jul-Aug;15(4):192-4.

Jawaharlal Institute of Postgraduate Medical Education and Research,
Pondicherry, India.
BACKGROUND: Lymphoedema is a major cause of morbidity in patients with
lymphatic filariasis. There is no effective medical treatment and the
results of surgery are uncertain. There are very few published studies
assessing the volumetric response to the use of sequential intermittent
pneumatic compression (SIPC) in patients. METHODS: A 12-celled instrument
capable of providing sequential compression from the distal
to proximal direction was used in 28 patients with unilateral
grades II (n=17) and III (n=11) filarial lymphoedema in a planned 4-week
session. The patients were followed up for 6 months after compression
therapy by water displacement volumetry. RESULTS: We found that 12 patients
with grade II filarial lymphoedema had >26% reduction in oedema
volume immediately after compression, but this reduction (>26%)
was maintained in only 7 at 6 months. The corresponding figures
for grade III filarial lymphoedema were 6 and 4, respectively.
The effect in grade III was less sustained than grade II.
No complications attributable to SIPC were seen. An added advantage
of SIPC was a significant decrease in attacks of
adenolymphangitis after compression when compared to pre-compression
frequency. These observations were seen even with non-compliance to both
foot care measures and use of bandages to maintain reduction in oedema
volume. CONCLUSION: SIPC reduces morbidity in filarial lymphoedema though
the effect is not sustained. It is simple, easy to use and could
form part of the morbidity control programme for lymphatic filariasis.