Page 45 - VOL 26 N. 72 - 2015

EFFECT OF MANUAL LYMPH DRAINAGE AND COMPRESSION BANDAGE ON HEMATOMA AFTER SUPRASPINATUS TENDINITIS RUPTURE
YESIM BAKAR, PT, PhD, Associate Prof., ELIF ZORGÖR, PT
Abant Izzet Baysal University, School of Physical Therapy and Rehabilitation, Bolu, Turkey
Introduction: Hematoma is an accumulation of blood in the tissues due to bleeding. It’s occure when blood vessels rupture, after tissue injury or by other damage. We report a case with a big hematoma in the right arm after a supraspinatus tendinitis rupture.
Materials & Methods & Results: Our case was 62 years old. After a supraspinatus rupture, an injection for inhibition was performed on the supraspinatus muscle. But 3 days after this application, he becames a hematoma on his right upper extremity (upper arm, elbow, arm, hand). He has extremly pain and pitting edema. We apply with very light pressure manual lymphatic drainage and begann from the axillary lymphatic nodes. Because of his pain, we could only drainge until the elbow. After 3 days, we could drainage up to the hand. The first 5 days we apply the compression bandaging with a very light pressure until elbow. After the first 5 days, we apply the badage up to the shoulder. The hematoma was reduced completly in the arm. But the edema was reduced after the 12th day. The patient donsn’t have pain and edema after manual lymphatic drainage and mild compressions bandage.
Conclusions: Lymphatic drainage and compressions bandages are an effective treatment method in posttravmatic-postoperative hematoma.
IS THERE AN INTEREST TO PERFORM TWICE DAILY SHORT-STRETCH MULTICOMPONENT BANDAGING DURING HOSPITAL INTENSIVE TREATMENT OF LOWER LIMB LYMPHEDEMA?
LESSERT C., LUTHI I., TOMSON D., MAZZOLAI L., DEPAIRON M.
Division of Angiology, Lausanne University Hospital, Lausanne, Switzerland
Introduction: Pressure exerted by short-stretch multicomponent bandages (MCB) on the limbs progressively decreases with edema resorption. The aim of this study is to assess whether intensive LO hospital treatment should include twice daily MCB using Picopress transducers to analyze pressure evolution in skin bandage interface.
Methods: Consecutive patients with chronic primary or secondary lower limb lymphedema (LO) were hospitalized for intensive treatment. Treatment consisted in twice daily (10 a.m. and 2 p.m.) skin care, manual lymphatic drainage (MLD), and short-stretch MCB until the thigh. MLD and MCB were alternatively performed by the same two experienced physiotherapists in all patients. Following MLD, all patients underwent MCB consisting in a first layer of cotton tubular protection, followed by wadding bandages, foam bandages (0,2 cm thickness at the foot and calf level, 0,4 cm at the tight), and a final short-stretch bandage (Rosidal K®).
Pressure exerted by the MCB was measured using the PicoPress instrument (Microlab®, Italy) soon after bandaging positioning (basal values) and 4 hours thereafter just prior to second daily MLD and application of a new bandage. PicoPress transducers were placed in the skin-bandage interface at the ankle and thigh levels. Pressure detected by the transducer was measured by a microprocessor digital gauge and visualized by means of an alphanumeric display. Patients were instructed to conduct “usual” life with no restriction in terms of mobility. PicoPress values were expressed in mmHg and results presented as difference between values obtained after 4 hours of compression and basal levels. Pressure was measured both in the lying and standing position. Statistical analysis was performed using the paired student t-test.
Results: 14 patients (50% women, mean age 59±3.7 years) were included in the study. Twelve patients presented with chronic secondary LO since an average of 188±45 months. A mean of 12±1 treatment sessions were performed. Average ankle and thigh pressure difference after 4 hours of MCB was as follows:
Conclusions: Data presented herein show that pressure exerted by MCB significantly decreases within few hours from application. This suggests that intensive LO treatment should include twice daily MCB in order to achieve constant pressure and likely enhance final treatment results.
Ankle (Δ mmHg)
Thigh (Δ mmHg)
Lying position
-13±2*
-11±2*
Standing position
-12±3*
-9±2*
42
THE EUROPEAN JOURNAL OF LYMPHOLOGY - Vol. XXVI - Nr. 72 - 2015