Pilch, U., Wozniewski, M., & Szuba, A. (2009). Influence of compression cycle time and number of sleeve chambers on upper extremity lymphedema volume reduction during intermittent pneumatic compression. Lymphology, 42(1), 26–35.

To assess the efficacy of different intermittent pneumatic compression (IPC) protocols on edema volume reduction in women with postmastectomy lymphedema

Study subjects were randomly allocated to four groups with different cycles and sleeves for IPC. All women underwent IPC treatment for five weeks, five times per week for one hour for 25 sessions in total. Arm volume measurements for both arms were performed before and after each session. Group I (n = 17) received one-to-one cycles of compression and interval (90 seconds each), with a single chamber sleeve. Group II (n = 9) received a one-to-one cycle of compression and interval (90 seconds each), with a three-chamber sleeve. Group III (n = 11) received a one-to-one cycle of compression and interval (45 seconds and 15 seconds, respectively), with a single chamber sleeve. Group IV (n = 20) received a one-to-one cycle of compression and interval (45 seconds and 15 seconds, respectively) with a three-chamber sleeve.

• The study sample was comprised of female patients with breast cancer-related upper-extremity lymphedema who were post-treatment.
• Mean age ranged from 39–80 years.

The study took place at Wroclaw Medical University, in Wroclaw, Poland.

The study used a randomized trial design.

• Arm volume measurements were performed by water displacement.
• Distance between the tip of the third finger and bottom of axillary fossa was determined for each extremity; each subsequent measurement was repeated to this distance and mean value was recorded.
• Degree of lymphedema was represented by a difference in volume between the swollen upper extremity and the health upper extremity and was expressed in percent.

Significant differences in edema (29%–47%) were observed in all groups post-treatment with the most significant decrease seen in Group IV. The least reduction was observed in Group III, with Groups I and II experiencing similar decreases. Further comparison revealed the 45 second cycles with a three compartmental sleeve proved almost twice as effective as the 45 second cycle with single compartment sleeve.

IPC can be effective in decreasing lymphedema in upper extremities in patients with breast cancer post-treatment. Further studies are needed to validate the finding of enhanced results with a shorter compression cycle and cyclic sequential massage.

• The sample size was small, with less than 100 participants.
• The description of the study population is limited (i.e., length of time post-treatment or extent of surgical intervention).

IPC devices may be efficacious in treatment of lymphedema. More studies are needed to compare pneumatic compression devices and determination of standard equipment for treatment. Nurses need to build awareness for prevention and early detection and early intervention.