Sawan, S., Mugnai, R., Lopes Ade, B., Hughes, A., & Edmondson, R.J. (2009). Lower-limb lymphedema and vulval cancer: Feasibility of prophylactic compression garments and validation of leg volume measurement. International Journal of Gynecological Cancer: Official Journal of the International Gynecological Cancer Society, 19(9), 1649–1654.

To determine the feasibility of conducting a larger trial to investigate effectiveness with use of compression stockings to prevent leg lymphedema after vulval cancer

Fourteen patients undergoing inguinofemoral lymphadenectomy were randomized to either the best supportive care (control group) or best supportive care plus the use of graduated compression stockings for six months. Patients were seen preoperatively and followed at four weeks, three months, and six months after surgery. Patients were asked to wear treatment stockings during the daytime for six months once mobile beginning no later than three days after surgery. Expected compliance with stockings was 10 hours per day for 180 days.

• The sample was comprised of 14 female patients with vulvar cancer undergoing inguinofemoral lymphadenectomy.
• Median age was 71.5 years with a range of 41–87 years.
• Mean body mass index was 29.4 with a range from 20.432.4.

• Single site
• Inpatient and outpatient
• Northern Gynaecological Oncology Centre, a tertiary referral center cover northeastern England

The study was a randomized controlled feasibility design.

Lower-limb volume was calculated just above the ankle to at least 4 cm below the perineum. Circumference of the limb was measured using an ordinary tape measure at 4 cm intervals commencing approximately 2 cm from the lateral malleolus. The Nottingham Health Profile was used.

Eleven of 14 patients complied with the entire visit schedule. Two patients in the study group had travel hardship and one patient was frail and therefore dropped off. Three patients in the control group failed to comply. Patients in the control group showed greater increase in mean leg volume while those in the treatment arm showed better performance based on leg symptoms and clinical examination.

Prophylactic use of stockings is feasible.

• The sample size was small (N < 30).
• The study was unblinded.

Although a small sample, quality-of-life measurements were equal in both groups. Further studies are needed to evaluate the role of compression garments in prevention of lower-extremity lymphedema.