Many physicians and therapists are choosing to treat lymphedema patients in their office or clinic. This simple protocol is easy to follow and can be performed by clinical personnel with minimal instruction. The protocol is as easy as taking blood pressure measurements.
**Upon immediate removal of the garment, there will be a waffling appearance to the extremity. In the indented portions a small redness may appear, this is due to the tissue gradient pressure of the sleeve. This appearance will subside. Times vary from 15 minutes up to 2 hours depending on the texture and characteristics of the extremity. Should there be no waffling appearance, the pressure should be checked, as it is likely that the pressure is too low.
Take base line measurements of the affected and unaffected extremity just prior to initial fitting.
After the gauge has been properly calibrated, the bladder portion of the pressure gauge is placed directly on the patient's extremity, under the strap to be gauged. Initially adjust the compression to 20 mmHg (reduce to 15 mmHg if patient reports discomfort). Repeat this process under each strap until the entire extremity is adjusted to 20 mmHg. (Lower extremity can be initially set 25 mmHg) Mark the strap with the removable markers so reproduction of this setting can easily be obtained without using the gauge each time.
Have the patient relax with the ReidSleeve on for an hour. Remove the ReidSleeve and take the same measurements as taken prior to initial fitting. In this small window of time, most patients will show a response to the ReidSleeve. If the patient shows any reduction, (most likely minimal in only one hour) the patient is instructed to wear the sleeve overnight and take measurements first thing in the morning upon removing the sleeve.
If the patient shows little to no response with the pressure set at 20 mmHg after one week, instruct them to increase the pressure by 5 mmHg (gauge should read 25 mmHg). Compression range of 20-30 mmHg generally provides effective reduction in limb size. In some cases, higher compression is required; however, the ReidSleeve should be loosened or removed if the patient reports pain or discomfort.
Gradient. Many therapists favor the use of a gradient pressure over the length of the arm or leg. The adjustability of the ReidSleeve is ideal for this use. Combined with the Precise compression gauge, the therapist can set and maintain the desired gradient of compression for the arm or the leg.
The goal is to obtain the lowest pressure that will provide effective reduction in limb volume. The ReidSleeve should be worn consistently and for as many hours in the day as possible. Most patients favor wearing the sleeve at night; however, any suitable period of time is acceptable (ie. watching TV, reading, relaxing). Our recommendations are for the ReidSleeve to be worn as long as possible during the night with an additional 1-2 hours during day until the edema is effectively controlled. Many patients find that wearing time can be reduced after effective control of the edema has been obtained.
It is important to monitor the limb's measurements. As the extremity reduces, the pressure being applied to the limb lessens. When reduction occurs, the straps should be readjusted to the effected range determined utilizing the pressure gauge. Move the markers to reflect the new strap setting.
After initial fitting, the patient can easily adjust their sleeve as their limb reduces. We recommend that patients obtain their own pressure gauge so they may be independent and confident that they have the correct pressure.