Bandaging is an important part of lymphedema treatment that can be used during the decongestive (Phase I) and maintenance phase (Phase II). Short-stretch bandages are used to reduce your swelling and help prevent fluid reaccumulation. Short-stretch bandages are applied at or near end-stretch, so once applied they help resist your limb from reswelling safely.
Multi-Layer Lymphedema Bandaging (MLLB)
Traditional bandaging for lymphedema is Multi-Layer Lymphedema Bandaging, or MLLB. There are usually 4-5 components of MLLB:
- Finger/toe gauze bandages: Non-adhesive, oven weave bandages are often used on the fingers and toes. These products are generally soft and stretchable for comfortable wear. They should be good at absorbing moisture to help avoid infections. Since the fingers and toes move often throughout the day, these bandages must fit well without slipping.
- Tubular stockinette: These lightweight stockinettes are used to protect the skin under the other layers of compression. Since they are placed directly on the skin, they should also be absorbent to help aid in infection prevention. You can cut a few pieces at a time so that you can wash them often and make sure you are always wearing a clean stockinette next to your skin.
- Soft padding bandage: The next layer applied is a comfortable padding bandage that provides optimal skin protection. These products help ensure even distribution of pressure from the short-stretch bandage layer. They also provide padding around bony areas such as your ankle or wrist bones.
- Foam pads/pieces: Often times lymphedema can be hard, or fibrotic. Special foam pieces can be used in these difficult areas to soften fibrotic tissue. Foam pads can also be used to protect the skin and fill in any gaps or indentations in order to make a nice shape for the next bandage layer to be applied. Foam pads can also be used to protect the skin and fill out any dips or indentions to make a nice shape for the next layer to be applied.
- Short-stretch bandage layer: This is the final layer of bandaging. Short-stretch bandages are bandages used specifically for lymphedema. While these may look a lot like the ACE® bandage that you see in your local pharmacy, they are quite different. They are specially made to provide higher compression when you’re moving (walking, exercising) compared to when you are at rest. They come in different widths and lengths and your CLT will often instruct you to change the size depending on what area of your limb you are wrapping. Expect to use multiple bandages to cover your limb.
2-layer bandaging is often used when a wound is present or to increase patient compliance. This system of compression bandaging consists of only two layers:
- Layer one: a padding bandage that exerts a slight compression force and helps to distribute the pressure evenly. This layer also protects bony areas. It is specially designed with a coating on the one side to prevent the bandages from slipping.
- Layer two: this second layer is a cohesive (sticks to itself) short-stretch bandage that is applied over the padding bandage. This bandage system can be worn up to seven days straight without removal.