MacDonald's Prescriptions & Medical Supplies

Maintain the reduced state

To maintain the results achieved by LymphaPress treatment, the patient must be committed to a regimen of elevation, skin care and the use of a graduated stocking or armsleeve, apply LymphaPress to reduce the limb's volume and eliminate the need for a second stocking fitting. The stocking or sleeve should be worn only when the lower or upper limb is not being pumped and the patient is ambulatory.	Graduated-Compression Stockings and Arm Sleeves should be prescribed with a pressure range of 50-60mm Hg for the lower limbs and 30-40mm Hg for the upper limbs. Medical Stockings are available in an extensive slection of sizes, styles and pressure ranges.
Medical Stocking thigh stocking,	Medical Stocking arm sleeve,

Pneumatic compression works

"Among the best conservative methods for the reduction of lymphedema is pneumatic comporession, which , when combined with tight elastic stockings or sleeves, has reduced the number of patients requiring surgery. Our experience with LymphaPress, a new sequential pneumatic device, has been very successful in this respect."⁷ LymphaPress is an important aid to the surgeon in performing operations for lymphedema of the lower and upper limbs. "It reduces the hospitalization period and postoperative infection rate and minimizes pain, as well as ensuring the patency of lymphatic venous anstomoses. We recommend this technique as a routine procedure in operations for lymphedema of the limbs, whether excisional or physiological."⁸

Indications

1. Primary lymphedema
a) Congenital (Milroy's disease)
b) Proximal obilteration
c) Distal obliteration

2. Secondary lymphedema
a) Postmastectomy
b) Groin disection

3. Venous disorders
a) Painful varicose veins
b) Chronic venous insufficiency
c) Crural ulcer

4. Dysfunction of the muscle pump
a) Paralysis of the lower limbs
b) Muscular contractions

Contraindications

1. Deep venous thrombosis
2. Acute infections of the affected limb
3. Decompensated cardiac failure

Note: External compression is not appropriate for indications related to or secondary to arterial insufficiency.

References

1. Zelikovski, Avigdor, M.D., et al., "A new pneumatic device for the treatment of lymphedema of the limbs," Lymphology, Vol. 13 (June 1980), 68.

2. Richmand, David, M.D., et al., "Sequential Pneumatic Compression for Lymphedema," Archives of Surgery, Vol. 120 (October 195), 1119.

3. Zelikovski, Avigdor, M.D., et at, "The LymphaPress - A new pneumatic device for the treatment of lymphedema: Clinical Trial and Results," Folio Angiologica, Vol. XXVIII (April 1980), 165.

4. Ibid 169.

5. Ibid 167.

6. Partsch, H., M.D., et al., "Experimental investigations on the effect of a pressure wave massage apparatus (LymphaPress) in lymphedema," Phlebolgie und Proktologie (May 1980), 124-128.

7. Zelikovski, Avigdor, M.D., et al., "The sequential pneumatic compression device in surgery for lymphedema in the limbs," The Journal of Cardiovascular Surgery, Vol. 24 (March-April 1983), 122.

8. Ibid 126.