1. Use of support and compression in lymphoedema/chronic oedema
DEFINITIONS
SUPPORT: the retention and control of tissues
COMPRESSION: the application of pressure to the skin and tissues
(Thomas 1990)

2. PRINCIPLES SUPPORT: use of low/non extensible garments or bandages.
Provides low resting pressure
and high working pressures in
response to movement

4. COMPRESSION Use of elastic, extensible garments or bandages
Provides sustained pressure

7. Principles of lymphoedema multi-layer bandaging
Use of padding/foam
-provide evenly graduated pressures to influence shape.
Use of layered short-stretch bandages
- low resting and high working pressures
- provide rigidity but comfort and movement
Bandaging to all swollen areas including toes and upper limb.

8. BANDAGE PRESSURE
THE PRESSURE PRODUCED BY A COMPRESSION BANDAGE CAN BE PREDICTED ACCORDING TO LAPLACE’S LAW:
P=TxNx4630
C x W
P = sub-bandage pressure
T= bandage tension
N = number of layers
C = limb circumference
W = bandage width

9. LAPLACE’S LAW THIS LAW SHOWS THAT SUB-BANDAGE PRESSURE WILL:
Rise with increasing bandage tension and number of bandage layers
Decrease with increasing limb circumference and bandage width.

13. TOE OEDEMA

15. Indications for multi-layer lymphoedema bandaging
Fragile, damaged or ulcerated skin
Lymphorrhoea
Distortion in shape
Limb too large to fit hosiery
Deep skin folds
Chronic skin changes

16. Contraindications of multi-layer lymphoedema bandaging
Severe arterial insufficiency
DVT
Uncontrolled heart failure
Uncontrolled hypertension
Severe peripheral neuropathy
Acute inflammatory episode
Active TB