Manjula Y, Kate V, Ananthakrishnan N.
Evaluation of sequential intermittent pneumatic compression for filarial
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.