Bandaging is an important part of lymphedema therapy that can be used during the intensive and maintenance phases. Short stretch bandages are used to support your patient's swelling and can also help move the fluid out of the tissues.
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.
- 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 the malleoli.
- Foam pads/pieces: Often times lymphedema can become fibrotic. Special foam pieces can be used in these difficult areas to soften this fibrotic tissue. Foam pads can also be used to protect the skin and fill out any skin folds to make a nice shape for the next layer to be applied.
- Short-stretch bandage layer: This is the final layer of bandaging. Short-strech bandages are specially made to provide higher working pressure and lower resting pressure.
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 short-stretch bandage that is applied over the padding bandage. This bandage system can be worn up to seven days straight without removal.