Sadoon, M., & Al-Atiyyat, N. (2013). The efficacy of manual lymph drainage for breast cancer–related lymphoedema. British Journal of Community Nursing, 18(Suppl.), S18–S22.
Purpose
STUDY PURPOSE: To assess existing research on the effectiveness of manual lymphatic drainage (MLD) as a means of preventing and/or managing lymphedema
TYPE OF STUDY: Systematic review
Search Strategy
DATABASES USED: Google Scholar, PubMed, CINAHL
KEYWORDS: manual lymph drainage, breast cancer–related lymphoedema
INCLUSION CRITERIA: Each article had to be available in full text, published in English from 2008 to the present, regarding patients with lymphedema after breast cancer treatment. Each article needed to define lymphedema, to describe the inclusion and exclusion criteria used for patient selection, the MLD technique used, the compression strategy used, and an evaluation of severity of lymphedema.
Literature Evaluated
TOTAL REFERENCES RETRIEVED: Nine references were retrieved.
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Level of evidence based on the Oxford Centre for Evidence-Based Medicine (Level 1: two systematic reviews; level 2: five randomized, controlled studies; level four: one cross-sectional descriptive study, one longitudinal observation study).
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 9
- TOTAL PATIENTS INCLUDED IN REVIEW: 1,850 (final sample); 1,807 with upper extremity, 43 with lower extremity
Phase of Care and Clinical Applications
PHASE OF CARE: Multiple phases of care
Results
Conflicting information regarding the effectiveness of MLD with variability in the application, duration, and frequency of MLD in the different studies
Conclusions
Authors suggested that MLD is unlikely to produce significant volume reduction when added to compression and exercise therapy. The characteristics of individual patients can affect the clinical outcomes.
Limitations
Further research into the efficacy of MLD is needed.
Nursing Implications
The current standard of care for lymphedema is complete decongestive therapy, which includes MLD, compression, skin care, and exercise. Current research on individual modalities are conflicting regarding MLD. More research is needed.