
Lymphedema pneumatic therapy is any form or method of therapy that massages the vascular and muscle group of the lower limbs using pneumatic, or air, pressure that is either powered electrically or by battery that applies a strong pneumatic pressure in sequence to the muscle group and venous system of the lower limbs to help prevent blood and fluids from pooling.
An pneumatic leg compression device typically consist of an inflatable garment that is worn over the leg as a boot, sleeve or wrap. There are two types, stand alone, powered by a 120 volt pump and battery powered which is portable. A stand alone unit consist of a pneumatic pump, a garment and a tube or series of tubes that connect the two. Battery powered units are compact and do not use tubes.
Note: SCD’s are typically used in critical care units. Most patients on bed-rest, are prescribed SCD’s unless they are contradicted by wounds, fractures (broken bones), blood clots or burns.
Most SCD home unit garments* typically contain 4-8 inner chambers, depending on the brand or model and size and length, while most hospital grade lymphedema compression garments can contain up to 10 inner chambers, or air pockets.
Physicians often prescribe pneumatic compression leg devices for venous and lymphatic conditions, e.g., blood pooling or clotting, when the tendency is expected or when if symptoms have not responded to less extensive therapies such as elastic compression, elevation, exercise or complex decongestive therapy (CDT).
Note: A word of warning when using lymphedema compression device home units without the supervision of a physician; If you are at risk for DVT or recovering from a recent acute DVT, you should NOT use a SCD intermittently. Leaving it off for even 1-2 hours and then putting it back on may cause an embolus or blood clot(s). A SCD should only be used intermittently on hospital patients who are bed-ridden. Any mobility, such as getting our of bed and sitting in a chair, if even for only an hour, the usage of an SCD should generally be discontinued. If continued, a Doppler may be used on the patient to make sure no new clot(s) has or have formed.
An pneumatic leg compression device typically consist of an inflatable garment that is worn over the leg as a boot, sleeve or wrap. There are two types, stand alone, powered by a 120 volt pump and battery powered which is portable. A stand alone unit consist of a pneumatic pump, a garment and a tube or series of tubes that connect the two. Battery powered units are compact and do not use tubes.
Note: SCD’s are typically used in critical care units. Most patients on bed-rest, are prescribed SCD’s unless they are contradicted by wounds, fractures (broken bones), blood clots or burns.
Most SCD home unit garments* typically contain 4-8 inner chambers, depending on the brand or model and size and length, while most hospital grade lymphedema compression garments can contain up to 10 inner chambers, or air pockets.
Physicians often prescribe pneumatic compression leg devices for venous and lymphatic conditions, e.g., blood pooling or clotting, when the tendency is expected or when if symptoms have not responded to less extensive therapies such as elastic compression, elevation, exercise or complex decongestive therapy (CDT).
Note: A word of warning when using lymphedema compression device home units without the supervision of a physician; If you are at risk for DVT or recovering from a recent acute DVT, you should NOT use a SCD intermittently. Leaving it off for even 1-2 hours and then putting it back on may cause an embolus or blood clot(s). A SCD should only be used intermittently on hospital patients who are bed-ridden. Any mobility, such as getting our of bed and sitting in a chair, if even for only an hour, the usage of an SCD should generally be discontinued. If continued, a Doppler may be used on the patient to make sure no new clot(s) has or have formed.
How does a sequential compression device work?
A SCD works by using prescribed settings to pneumatically massaging and squeezing the muscles in the leg to increase the flow of blood back to the heart. A sequential compression device also helps stimulate the body’s own clot dissolving mechanisms.
A SCD can be knee-high or calf length and the choice of which one to use depends on the physician’s preference. Each hospital (and manufacturer) has protocols on the use of a SCD. Pneumatic lymphedema compression devices are widely used for the prevention of deep vein thrombosis (DVT). They are also used to treat a wide variety of circulatory disorders as well as for treating bruising and swelling resulting from orthopedic surgeries such as joint replacement.
A SCD can be knee-high or calf length and the choice of which one to use depends on the physician’s preference. Each hospital (and manufacturer) has protocols on the use of a SCD. Pneumatic lymphedema compression devices are widely used for the prevention of deep vein thrombosis (DVT). They are also used to treat a wide variety of circulatory disorders as well as for treating bruising and swelling resulting from orthopedic surgeries such as joint replacement.
Common uses for a leg lymphedema compression device
Promotes good circulation. Treats bruises and swelling resulting from orthopedic surgeries such as joint replacement Relaxes tense muscles. Stimulates muscles to keep you moving after long periods of inactivity. Eases stiffness. Relieves fatigue and muscle leg pains. Treating infected ulcerated legs Reduce swelling caused by lymphedema Preventing chronic venous insufficiency (CVI) Preventing deep vein thrombosis (DVT) Preventing venous ulcers Helping ambulatory, as well as non-ambulatory people, soothe sore muscles. Compression therapy for treatment lymphatic and venous disorders |
A - Peristaltic Massage Mode and B - Sequential Circulation Mode
|
How does a lymphedema compression device work?
The plastic garment is applied over or around the arm or leg (for the purpose of this article I will speak to only a SCD for the leg), depending on the type (configuration) and model, and the pumping unit inflates and deflates its inner chambers with air in a predetermined sequence which applies pressure to the muscles of the legs, and a corresponding sequential compression to the veins of the legs.
This serial compression on the muscles and veins mimics the action of walking and results in moving blood through the veins towards the heart and preventing pooling of blood in the lower limbs. A SCD is relatively comfortable to wear and will not restrict leg movement.
Air pressure creates gradient compression on the legs muscles and veins (often over thromboembolic stockings) to provide a massaging effect which imitates the natural flow of lymph from the distal end of the limb (foot) toward the trunk of the body, mimicking the action of leg movement, such as walking, to move blood and fluids through the veins towards the heart.
The chambers of the garment are sequentially inflated from ankle to knee (or mid thigh) to a maximum pressure of 45-50 mmHg at the ankle, 35 mmHg at the calf, and 30 mmHg at the thigh (hence the term “gradient” compression). The duration of compression is typically 11 seconds with a 60 second relaxation period between compressions depending on the brand of the unit and its configuration.
This duration occurs after each heartbeat, every other heartbeat or every third heartbeat, and is then at rest during moments of heart contraction and arterial inflow into the lower extemities.
This lymphedema compression allows the heart to empty its blood easier thus freeing it from having to work to return blood to the heart and decreasing the work of the heart contraction.
This serial compression on the muscles and veins mimics the action of walking and results in moving blood through the veins towards the heart and preventing pooling of blood in the lower limbs. A SCD is relatively comfortable to wear and will not restrict leg movement.
Air pressure creates gradient compression on the legs muscles and veins (often over thromboembolic stockings) to provide a massaging effect which imitates the natural flow of lymph from the distal end of the limb (foot) toward the trunk of the body, mimicking the action of leg movement, such as walking, to move blood and fluids through the veins towards the heart.
The chambers of the garment are sequentially inflated from ankle to knee (or mid thigh) to a maximum pressure of 45-50 mmHg at the ankle, 35 mmHg at the calf, and 30 mmHg at the thigh (hence the term “gradient” compression). The duration of compression is typically 11 seconds with a 60 second relaxation period between compressions depending on the brand of the unit and its configuration.
This duration occurs after each heartbeat, every other heartbeat or every third heartbeat, and is then at rest during moments of heart contraction and arterial inflow into the lower extemities.
This lymphedema compression allows the heart to empty its blood easier thus freeing it from having to work to return blood to the heart and decreasing the work of the heart contraction.
What is a SCD boot?
A pneumatic lymphedema compression boot is an inflatable garment in the shape of a boot that is comprised of an electrical pumping device which inflates and deflates the boot according to a set number of times and pressures.
How important is a lymphedema compression boot?
A Pneumatic lymphedema compression boot is a simpler means of treating extreme or abnormal swelling due to a venous disorder such as lymphedema that often occurs in the legs and feet. By that I mean that they are much easier and less expensive and can be used at home as opposed to making several trips back and forth to a health care facility.
Note: It’s always to first confer with your physician or health care specialist to determine what settings will best treat your particular condition. Applying too much pressure could cause serious damage.
How important is a lymphedema compression boot?
A Pneumatic lymphedema compression boot is a simpler means of treating extreme or abnormal swelling due to a venous disorder such as lymphedema that often occurs in the legs and feet. By that I mean that they are much easier and less expensive and can be used at home as opposed to making several trips back and forth to a health care facility.
Note: It’s always to first confer with your physician or health care specialist to determine what settings will best treat your particular condition. Applying too much pressure could cause serious damage.
Tips for selecting a lymphedema compression device
1. Rely on your doctor’s recommendations on what type of leg lymphedema compression device you should purchase which may include one of several popular brands (see below). Such devices can be somewhat complicated to operate if you’re new to using them and may require assistance.
It’s tempting to purchase an off-name brand to save a few dollars but if your doctor or health care physician who is familiar with your specific health situation makes a recommendation for a tested product for your situation, it’s advisable to follow his/her advice .
1. Rely on your doctor’s recommendations on what type of leg lymphedema compression device you should purchase which may include one of several popular brands (see below). Such devices can be somewhat complicated to operate if you’re new to using them and may require assistance.
It’s tempting to purchase an off-name brand to save a few dollars but if your doctor or health care physician who is familiar with your specific health situation makes a recommendation for a tested product for your situation, it’s advisable to follow his/her advice .
- Don’t purchase a used or refurbished model – you don’t know what you’re getting! Going with a used model could put your health at risk if it doesn’t work properly. The investment you make in a compression pump machine will be one of the most important investments you make because it will help you live a longer and healthier life, allowing you to succeed at work and home and spend more time with family and friends. Unauthorized dealers may purchase your sequential compression device from a middleman. They may not work properly and you will never know. In addition, you may pay a significant amount of money and not have warranty coverage. The risk isn’t worth it.
- Avoid websites that offer cheaper brands of lymphedema products. Instead look for a website that offers machines with warranties from the quality manufacturers and offers free customer care and support. When you’re buying equipment that costs you or your insurance company hundreds to thousands of dollars you deserve access to customer support if you need it.
- Look for brands recommended by recognizable organizations, such as the American Diabetes Association (ADA). If you’re unsure about a specific brand contact the manufacturer directly or one of their distributors for information about their product offerings, warranties, and customer service so you can compare lymphedema compression devices are sold to the consumer under a variety of terms, e.g., SCD*-boots, Portable Sequential Compression Device, Compression-Boot for Edema, Sequential Compression-Boot, Leg Compression Device, Lymphedema Pump, and Post- Surgical Anti-clot Leg Device.