3.4. MULTI-LAYER COMPRESSIVE SURROUNDING

Multilayer compression bandaging is the mainstay of intensive care for lymphedema. The compression bandage uses inelastic bandages with low stretch that provide high pressure during movement and low pressure during rest, facilitating lymphatic flow. It involves wrapping the limb with multiple layers of high tension elastic bandage in order to create pressure during movement. This gives impetus to the lymph fluid in an upward direction. The compression bandage compresses the limb only during movement, but not when the limb is stationary. The difference in pressure in the member between rest and movement facilitates the pumping of lymph and prevents its further accumulation. In addition to reducing swelling, it offers restoration of limb shape, reduction of skin changes and skin support. Although there is no evidence to support this, clinical experience has shown that elastic bandages should be changed every day for the first 7 days and every 2-3 days after the lymphedema has subsided to some extent.(Mason, 2001, Linnitt and Davies, 2007, Hopkins, 2008). 
Compression Bandage requires materials for Skin Care, Finger Bandage (hand or foot), tubular bandage, soft synthetic wool or foam, dense foam, non-elastic bandage and adhesive tape. The compression bandage that will be done in the physical therapy department of the P.G.N. Larisa will be done with materials that the patient will purchase from an orthopedic shop already through his health booklet. There will be some dressings in stock in the Physiotherapy Department (Chapter 4). Bandaging is done for the upper limb with the patient in a sitting position, while for the lower limb with the patient initially in a supine position (tibia bandaging) and then with the patient standing in a specially constructed lift (femoral bandaging) .