Case Studies and Clinical Evidence

Using compression hosiery to prevent rebound swelling

Author(s): Marie Todd
Date: 1 October 2015

The management of chronic oedema often consists of a programme of compression bandaging to reduce swelling and improve skin changes and limb shape, followed by patient self-care management in compression hosiery. Occasionally, patients experience rebound swelling and require further episodes of bandaging. In such cases, a thorough assessment of the causes of the rebound swelling should be carried out so that they can be eliminated. By evidencing three case studies, this article demonstrates that Haddenham Custom Goldpunkt garments can be useful in preventing rebound swelling, making it a cost- and resource-effective method of managing stubborn chronic oedema and lymphoedema.

Microfine Toecaps: An Innovative and Cost-Saving Solution

Author(s): Jane Wigg, Rebecca Elwell
Date: 1 May 2015

This article discusses the use of Microfine toe caps (Haddenham, UK) for the treatment of digit swelling. It will discuss the indications and contraindications of the device and offers some case studies where toe caps have been used in clinical practice. The use of the Microfine toe cap offers an alternative to toe bandaging, has many different applications and can be safe and time-saving to apply when used appropriately following a full and holistic assessment.

Use of compression shorts in the management of lymphoedema and lipoedema

Author(s): Jane Wigg, Natalie Lee
Date: 17 November 2014

Compression therapy is the mainstay of treatment in the management of lymphoedema and lipoedema. However, due to variance in the location, severity and type of the condition, patients often have to compromise on garments to ensure that the affected area of oedema is controlled. This article discusses the use of Veni compression shorts (Haddenham Healthcare) and Capri garments as an alternative treatment option to full-leg compression garments. The article explains treatment areas and conditions where the application of these garments will enhance care—for example, for trunkal swelling—and where compression may not generally be required—for example, in the feet

Prospective multicentre observational study of lymphedema therapy (Mobiderm)

Author(s): I. Quéréa E. Preslesb et al
Date: 1 November 2014

Prospective multicentre observational study of patients with unilateral lymphedema. The primary objective was to assess lymphedema volume variation between baseline, the end of intensive phase and 6 months later. Secondary objectives were to assess the frequency of heaviness limiting limb function and treatments safety predictors for volume reduction.

Reference Publications for the Moisture Meter

Author(s): Delfin Technologies Ltd
Date: 4 September 2014

A list of recerences for the Moisture MeterD Compact including it's use in the assessment of Lymphoedema.

Oedema Management in Spinal Cord Injuries

Author(s): Sue Lawrence, Ruth Peachment
Date: 13 November 2013

Spinal cord injury (SCI) patients are prone to the development of chronic oedema due to gravitational influences on dependent limbs, reduced mobility and therefore reduced muscle pump action. In 2010, a collaborative Clinic commenced between the Occupational Therapy department at the National Spinal Injuries Centre and Lymphoedema Service at Florence Nightingale Hospice, to address this problem and challenge entrenched views of this being an acceptable and inevitable consequence of SCI.

The use of low level light therapy in the treatment of head and neck oedema

Author(s): Natalie Lee, Jane Wigg, James D Carroll
Date: 1 November 2013

The focus of this article is to present evidence supporting the use of low level laser therapy (LLLT) as a specialist treatment for patients with head and neck oedema. Information obtained from a critique of relevant literature will be utilised to discuss the treatments available for those with head and neck oedema, highlighting how outcomes may be improved and quality of life enhanced, when LLLT is offered as part of a holistic treatment plan. A case study using LLLT is also presented.

Redefining essential care in lymphoedema

Author(s): Jane Wigg, Natalie Lee
Date: 24 October 2013

The awareness, diagnosis and management of chronic oedema and lymphoedema is improving. The enduring treatment format for the condition has always been regarded as the ‘four cornerstones’ of care for maintenance therapy in the UK. However, with changes in technology, availability of additional treatments and increased research and studies, this baseline is changing. This article outlines some of the recent changes and advancement in diagnostic tools and new technologies used in diagnosing and managing lymphoedema and chronic oedema. Emerging therapies will be introduced, as will other aspects of care that may now be considered ‘essential care’ in the management of lymphoedema and chronic oedema.

Case Study to highlight the use of Haddenham ETO 11P in an extraordinary way.

Author(s): Rebecca Elwell
Date: 11 October 2013

The increasing numbers of bariatric patients seen in Lymphoedema clinics in the U.K. pose a number of management challenges but one such difficulty is the management of the often seen, lymphoedematous abdomen or apron with associated skin changes and lymphorrhoea.

Getting the right fit: made-to-measure garments for lymphoedema management

Author(s): Natalie Lee, Jane Wigg
Date: 5 April 2013

The purpose of this article is to discuss the use of custom made compression garments in the management of lymphoedema and chronic oedema. Patients often present to therapists with inappropriate, ill-fitting garments that can contribute to an increase in oedema and poor limb shape. Patients frequently report garments as being uncomfortable and therefore intolerable leading to a lack of concordance with wearing garments. The selection and fitting of the correct garment can affect outcomes and the patients’ quality of life. The focus of this article is to increase the health professionals’ knowledge and skills in the selection, measurement and fitting of custom made garments to ensure correct fit and increased concordance when compression garments are prescribed.

Selecting Compression Garments For Treating Chronic Oedema

Author(s): Natalie Lee and Jane Wigg
Date: 1 October 2012

The article focuses on the use of compression for chronic oedema and lymphoedema. It will provide information and advice to community nurses to aid the decision making process when selecting compression garments. It will discuss the extensive options available from the Veni range of compression garments for lower limb swelling from Haddenham Healthcare and through case studies demonstrate its versatility in practice.

Microfine glove and toe caps and their use in lymphoedema management

Author(s): Gail Close
Date: 1 October 2010

Lymphoedema garments have progressed in the last 10 years, so gone are the days when only one colour is available (that lovely beige!). How many patients would have to be persuaded to wear their compression hosiery in that desirable colour? Not just have the colours become more acceptable, so have the fabrics. There are a wide range of compression gloves available to the lymphoedema specialist to fit on the patient but that cannot be said of toe caps. The Microfine toe cap is the only one available as an off-the-shelf garment, and when the lymphoedema is deemed to be manageable in these garments, it offers an alternative to flat knit. The Microfine glove and Microfine toe cap are adaptable and can offer colour options and a fabric that is less bulky and fine. It also allows therapists to trim the length of each digit for a better fit without reducing compression. The author will present three case studies of patients that are using.

Case study of scrotal oedema in a 75 year old patient with metastatic cancer of the prostate

Date: 5 October 2009

There has recently been a lot published about the use of the Whitaker pouch available from Medi UK in the management of scrotal oedema but in clinical practice at the Lymphoedema clinic, University Hospital of North Staffordshire, the ETO 11P scrotal garment available from Haddenham Healthcare has proved to be a suitable alternative.

An evaluation of the use and response of low level laser therapy

Author(s): Jane Wigg, Samantha Hammond and Cheryl White
Date: 5 October 2009

Laser has been used in the management of lymphoedema and other problems for many years. Reported therapeutic effects are softening of tissues, reducing pain and heaviness and improving the immune system (Carati et al 2003, Tadakuma 1993). Thelander and Piller (2000) report improvements in scar tissue and softening as main changes in their initial trials. The UK has been slow to adopt this technology but since gaining its CE registration WLS has commenced this treatment.

Use and response to treatment using low level laser therapy

Author(s): Jane Wigg
Date: 1 October 2009

Laser therapy for lymphoedema treatment has been used internationally for many years but has been slow to be accepted in the UK. The science behind the technique and its effectiveness in reducing fluid viscosity and encouraging motoricity of the lymphatics has been reported (Lievens, 1987; Eliska and Eliskova, 1997). The evaluation reported in this paper observed the response of 12 patients to laser treatment for lymphoedema. All the patients reported a reduction in tissue thickening and 83% of patients noted improvements in range of movement. In addition, 43% of patients saw an improvement in scar appearance.

Gross lymphoedema: A creative approach to successful care

Author(s): Jane Wigg
Date: 25 August 2009

This case report shows the treatment and support needed to assist a patient with gross lymphoedema. The combined treatment approach proved successful with limb volume reduction and an increase in the patient’s mobility and confidence

Measuring sub-bandage static and dynamic compression pressures

Author(s): Suzanne Humen Davey
Date: 1 July 2006

Many compression bandages and devices are available for treating limb edema, lymphedema and ulcers. Since the pressures achieved by these play a role in their therapeutic usefulness it is instructive to examine some of these pressure features under different conditions. Of particular interest is the pressure measured between the bandage and the limb variously called interface, surface or sub-bandage pressure. When a compression bandage or device is applied to a limb and the limb is at rest, the pressure is called the resting or static pressure. When the limb is moving and its muscles are contracting, then the pressure change is called the dynamic or working pressure. Each pressure has its own specific role in therapeutic processes [1]. The main purpose of this presentation is to provide initial examples and illustrations of some of the clinically relevant features of various bandages and devices under different conditions. The main goal of this work is educational and is not intended as a comparative study of different features among different products. This would require a much larger undertaking for such comparisons to be scientifically meaningful.

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