THE ROLE OF SHORT-STRETCH BANDAGES IN THE MANAGEMENT OF LYMPHEDEMA
Modified from a blog by Joachim Zuther (used with permission from Joachim Zuther www.lymphedemablog.com)
Compression therapy, like manual lymph drainage (MLD), exercises and skin care, is a main element of Complete Decongestive Therapy (CDT).
In most cases of Lymphedema, the elastic fibers in skin tissues affected by Lymphedema are damaged and unable to provide adequate resistance against the musculature working underneath, and the blood and lymph vessels within these tissues. External compression compensates for the elastic insufficiency of the affected tissue, providing the resistance necessary to maintain the reduction of the swelling and to prevent
re-accumulation of Lymphedemateous fluid. Crucial in Lymphedema management is to provide the skin tissues with a solid counterforce against the muscles working underneath, particularly while standing, sitting, walking, or performing therapeutic exercises.
Why short-stretch bandages?
There are two distinct types of compression bandages – short-stretch and long-stretch bandages. The difference refers to the extent the bandages can be stretched from their original length. Short-stretch bandages are made from cotton fibers, which are interwoven in a way that allows for about 60% extensibility of its original length, whereas long-stretch bandages, commonly known as “Ace” bandages contain polyurethane, which allows for an extensibility of more than 140% of the bandages’ original length.
The high working pressure of short-stretch cotton bandages provide the necessary solid counterforce and make them the preferred compression bandage in the management of Lymphedema. Due to the low resting pressure of short-stretch bandages, tourniquet effects are prevented –
provided these bandages are applied correctly.
Long-stretch (“Ace”) bandages have the exact opposite effect and are not suitable for
Lymphedema management. The low working pressure these bandages provide does not
offer adequate resistance, and fluid would inevitably accumulate. In addition, the high resting pressure of long-stretch bandages could constrict veins and lymph vessels during rest.
Koban Wrap is an alternative to short stretch bandages providing the same type of compression, which once applied can stay on for several days with less volume, waterproof and has less slippage due to the cohesive quality.