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INTERMITTENT

COMPRESSION
H E N N A WO N G 20160606029
MARIA ANGELINA NEONBASU 20160606057
WHAT IS INTERMITTENT
COMPRESSION?
• Pumps attached to a boot or sleeve that forces air or water (usually chilled water) into the
sleeve. The boot or sleeve is fitted around a joint so that when it inflates, it applies pressure to
the joint. A timing mechanism turns the pump on and off so the sleeve alternates inflating and
deflating, thus providing intermittent compression.
• Classified as:
1) Pneumatic (air)
2) Cryocompression (chilled water)
3) Circumferential (all at once)
4) Sequential (distal to proximal)
INDICATIONS

• Postraumatic edema
• Postoperative edema
• Chronic edema; primary and secondary lymphedema
• Venous stasis ulcers
• Persistent swelling caused by venous insufficiency
CONTRAINDICATIONS

• Peripheral vascular disease


• Arteriosclerosis
• Deep vein thrombosis
• Local superficial infection
• Edema secondary to congestive heart failure
• Ischemic vascular disease
• Gangrene
• Dermatitis
• Acute pulmonary edema
• Displaced fractures
DOSAGE

• Inflation pressure
1) Between 40 and 60 mmHg for upper extremity
2) Between 60 and 100 mmHg for lower extremity, but no greater than the patient’s diastolic
pressure
• On-off time sequence (45-90 sec on/15-30 sec off; 3:1 duty cycle)
• Duration of treatment:
1) 2-3 hours → Lymphedema
2) 2 hours → Traumatic edema
3) 2,5 hours (3x/week) → Venous ulcers
4) 4 hours (1-3 hour sessions) → Residual limb reduction
PHYSIOLOGICAL EFFECT

• Improve blood flow and reduce dependent edema.


• Increased pressure in the interstitial fluids enhance venous and lymphatic return.
• Decreased capillary perfusion: decreased cellular activity and collagen synthesis.
Comparison of Intermittent Pneumatic Compression
with Manual Lymphatic Drainage
for Treatment of Breast Cancer-Related
Lymphedema
JOURNAL
• Breast Cancer Related Lymphedema (BCRL) → excessive and persistent accumulation of fluid
and extracelullar proteins in tissue spaces, due to inefficiency of lymphatic drainage system.
LYMPHEDEMA (LE)
MATERIAL & METHODS
• 30 patients. Divided into two groups.
 1st group: MLD and compression bandage
 2nd group: IPC and SLD
• Sociodemographic and clinical characteristics and risk factors related to LE of the patients
were assessed and recorded.
• Treatment for LE 3 days in a week, and every other day for 6 weeks.
• Arm circumferences were measured before and the 1st, 3rd, and 6th weeks of the treatment.
• EORTC-QLQ and ASES tests were performed to asses the QoL before and after 6-week
treatment.
2 GROUP: IPC + SLD (SELF-
ND

LYMPHATIC DRAINAGE)
• IPC stimulating the lymphatic flow by compression-decompression periods with 25mmHg
pressure and different cyclic manner.
• IPC was applied for 45 min duration for every treatment period.
• SLD is trained by physioterapist.
• SLD is performed everyday for 15 min. The daily records on SLD of the patients were checked
weekly.
RESULT & CASE ANALYSIS

• Several controlled studies have documented IPC’s effectiveness when used continually and in
combination with other options.
• Although MLD was superior to IPC method in regard to volume decrease of the arm with LE
of the patients in both group were not found to be significant.
• The volume decreases had been reported to be as 48% and 25% by MLD and by IPC,
respectively.
CONCLUSION

• The combination treatment modalities including IPC with SLD, and MLD with compression
bandage, are both effective and tolerable modalities, along with skin care and exercises in the
treatment of LE caused by breast cancer treatment.
• Even though MLD and compression bandage therapy seems to be slightly superior in terms of
some quality of life scores, the IPC with SLD can be the choice of treatment in LE for
applicability at home without interruption of regular life.
BANDAGES
THANK YOU 

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