M8: 4

Question 1

How often do lymphedema garments need to be replaced?

Answer 1

Every 6 months or sooner if it’s stretched

Question 2

Compression garments: prophylactic use

Answer 2

• air travel

- other periods of prolonged immobility or pressure change

Question 3

CDT precautions and relative contraindications

Answer 3

• acute infections
• uncontrolled asthma
• cardiac edema
• malignancy
• acute bronchitis
• renal insufficiency
• HTN
• hx of cancer tx
• sx of lymphedema worsen during tx phase
• pt’s health declines

Question 4

Bandaging precautions and relative contraindications

Answer 4

• LE arterial dz
• acute infection (think cellulitis)
• HTN
• paralysis
• DM
• asthma
• malignant lymphedema
• cor pulmonale

Question 5

Why is a mechanical compression pump unlikely to provide lasting improvement for lymphedema?

Answer 5

1. Only squeezes water out, not protein

2. Stops at edge of sleeve, leaving a buildup there instead of flushing it out completely

Question 6

Who might be appropriate for mechanical compression?

Answer 6

Someone who

• can’t or won’t tolerate lymphedema bandaging
• has minimal fibrotic changes to subcutaneous tissues
• can’t come daily for tx

Question 7

What are the specific guidelines for applying mechanical compression?

Answer 7

• start at 20 mmHg » 45 (don’t exceed 45)
• compression cycle: 30 s
• rest cycle: 5s (UE), 10s (LE)
• tx time: start at 20 mins (if no complications, add 10m per day up to 1 hour

Question 8

What is prospective surveillance?

Answer 8

• preventative tx
• monitoring side effects that can occur with these tx
• prepare to avoid those situations
• trying to detect problems at the earlier stage

Question 9

How is prospective surveillance different/better than traditional approaches to tx of cancer-tx complications?

Answer 9

• costs lest

- more traditional approach is curative, or reactive

Question 10

Things to instruct a pt on with lymphedema prevention?

Answer 10

• skin care (avoid trauma to reduce infection risk)
• activity/lifestyle
• avoid limb constriction
• compression garments
• temperature extremes