Optimisation of intermittent pneumatic compression in patients with lymphoedema of the legs

Background: Intermittent pneumatic compression (IPC) has established itself as a cornerstone in the combined decongestive therapy (CDT) of leg oedema, however, there is little evidence on the degree of volume shifts. Objectives: We performed continuous volume measurements during CDT to quantify volume shifts in a controlled trial. In addition, "wrapping/underpadding" and medical compression stockings were evaluated regarding decongestion and leg oedema, respectively. Materials & Methods: The volume reduction of CDT in patients with lymphoedema of the legs was measured. The additive decongesting effect of a padding surrounding the leg under the lymph cuff (IPC +) was evaluated. The efficacy of compression stockings in the maintenance phase was analysed. Results: Volume reductions were observed on the thigh (2%) and lower leg (5%) utilising IPC. Further significant volume reduction of the thigh (6%, p < 0.001) and lower leg (8%, p = 0.002) was observed with IPC +. Considering the thigh volume, patients with thigh-length compression stockings in the maintenance phase showed a significantly less pronounced increase in volume than patients with below-knee compression stockings (98% vs. 101% after six weeks; p < 0.05). Conclusion: The additional padding of the leg during an IPC session induces significantly more pronounced volume reduction. Medical compression stockings help to prevent volume increase in the maintenance phase.