Hi Suzanne,
I tried to find evidence for the efficacy of the pump, and I found only
little. There is a lot of (non-evidence based) information about the pump,
written by experts in Lymphology. Most lymphologists agree that the pump
must be adjuvant, and not a treatment alone. I also believe the pump could
be beneficial in mild Lymphedema cases, and not when the edema is big.
There was a randomized clinical trial in Lymphology vol 31, No 2 june 1998
where the pump was compared with manual lymphatic drainage. The manual
lymphatic drainage was a little bit better.
In the discussion of cost-efficacy there would be a favor for the pump, BUT,
the pump can has a danger of fluid accumulation at the proximal end of the
sleeve. If this fluid accumulation turns into fibrotic tissue, the patient
has more trouble than before the pump started. Judith Casley-Smith did a
lot of research on cost-efficacy for the several treatment methods.
The treatment of Lymphedema should nearly always be a combination of
several treatment methods. Exercise, good information on skin care,
compression-therapy by bandages, sleeves etc is just as important as the
manual lymphatic drainage. I use to call this treatment regime: complex
decongestive therapy (CDT or CPT). In my practice the pump is often a part
of the treatment, with low pressures (50 mmHg).
In my opinion (please comment me) the case you describe will be best off
with a compression sleeve. The patient will be independent of any therapist
or pump. An adequate sleeve will definitely prevent worsening of the edema.
Hope this helps
Tom Zee
Netherlands
-----Oorspronkelijk bericht-----
Van: Resnick/Solomons <[log in to unmask]>
Aan: [log in to unmask] <[log in to unmask]>
Datum: maandag 16 november 1998 18:02
Onderwerp: compression pumps
>Hello all
>Would like to ask any of you working with oncology patients if you have
>any knowledge of the efficacy of compression pumps vis a vis manual
>lymph drainage in the prevention of lymphadoema. This pertains to a 37
>year old mother of four who underwent a level 3 axillar dissection
>followed by radiation to the breast and axilla 18 months ago who
>occassionally gets some swelling distally iin that extremity. Any
>thoughts on this would be appreciated.
>Suzanne
>
>
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