NEW YORK CITY – An eight-chamber compression device significantly reduces swelling and quickens wound healing in patients with lymphedema, ulcers, varicose vein disease and related conditions. Intermittent pneumatic compression pump (Sequential Circulator Model 3008, Bio Compression Systems) therapy showed greater benefits than standard care in a recent Stanford University study of post-breast cancer treatment patients with lymphedema in their arms.
The device reduced swelling by 45.3% in the study, compared with a 26% reduction with standard treatment known as decongestive lymphatic therapy (DLT). DLT includes manual lymphatic massage, multilayer compressive bandaging and compressive garments.
"We’ve found a certain amount of success," said Charles La Rosa, MD, director of Vascular Surgery at Southside Hospital, Bay Shore, NY.
La Rosa said many of his patients have stasis ulcers because their blood is not circulating correctly and swelling makes the skin tighter and more prone to injury. Intermittent pneumatic compression is a pleasant way to improve circulation, he said. "They’re getting a massaging effect. It’s soothing and it relieves the swelling."
The system features a compartmentalized sleeve designed to fit each patient. Patients are trained in their homes how to put it on and use it, said Owen J. Murtagh, director of OJ Medtech Inc., Moonachie, NJ, which provides the therapy and support to patients.
"It’s the closest to mimicking the body’s natural functions," Murtagh said. The eight-chambered sleeve provides a "soothing, milking-like effect" on the patient’s arm or leg and the effect moves in cycles from the toes or fingers toward the body. A patient elevates the arm or leg then relaxes during the therapy, typically one to two hours a day to start.
"After an hour of therapy we take the sleeve off the extremity and do the post-measurements, and the patients can’t believe the reduction," Murtagh said. "The patients love it, which means they’re going to be compliant."
For those with wounds, the sleeve is designed to bypass an open wound area.
The Stanford study was a randomized, crossover, two-month study that compared the therapy as an adjunct to standard therapy in 29 patients with stable post-mastectomy arm lymphedema. Patients in the first group used a compression garment and self-applied manual lymphatic drainage; those in the second group did the same but added the intermittent pneumatic compression pump for one hour daily. All patients crossed over to the alternate therapy after one month. They were evaluated at the beginning of the study, after the first and second month, and after six months for limb volume, skin tautness and range of motion of the limb.
The treatment cannot be used on patients with deep vein thrombosis, active infection or those with congestive heart failure, Murtagh said. And it’s not a cure-all; patients have to go on a strict diet and do some exercise to improve their diagnosis, he said.
More extensive studies are pending, La Rosa said. The device is FDA-approved and covered by most insurance companies but not Medicare.
"I think it actually is a wonderful form of treatment that needs to be made available to more patients," he said.
