Kasseroller, R.G., & Brenner, E. (2010). A prospective randomised study of alginate-drenched low stretch bandages as an alternative to conventional lymphologic compression bandaging. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 18(3), 343–350.

To determine whether a difference exists between conventional and alginate bandaging in regard to lower-volume increase or re-filling of the lymphedema when the bandages are applied in periods with reduced decongestive therapy.

The study included an A group and a B group who received 22 days of treatment with manual lymphatic drainage (MLD) including three inpatient weekends. On inpatient weekends low-stretch compression dressing and alginate semi-rigid bandaging were compared. Patients using low-stretch compression dressings (Group A) had bandages applied Friday evening after MLD and then again on Saturday and Sunday after receiving intermittent pneumatic compression (IPC); patients were instructed to not remove bandaging during sleep. Group B used alginate semi-rigid bandages and also were bandaged after MLD on Friday. Patients were instructed to not remove this bandage for the entire weekend. IPC took place in this group with the bandage remaining in place. Volumes were measured prior to bandaging on Friday and then again on Monday prior to MLD.

• The sample (N = 61) was comprised of female patients with breast cancer.
• Mean age of patients was 57.4 years ± 8.926, with a range of 28–81.
• Five patients had a modified mastectomy and 56 had a lumpectomy.
• Thirty-five patients underwent radiation therapy with three receiving adjuvant therapy.
• Six months prior to admission in the study, 41 patients underwent non-standardized treatment with MLD and a compression garment.

• Single site
• Inpatient setting
• Austria

The study used a randomized controlled trial design.

• Volume measurement by Kuhnke, starting at ulnar styloid process to proximal circumference, was measured every 4 cm.
• Sonograph of skin thickness at middle-ventral upper arm, middle-ventral forearm, and the middle-back of the hand.

There was a statistical difference between the two groups in terms of volume depletion on days 1–5 (p = 0.010). Days 5–8 had a significantly smaller difference (p = 0.001) and days 8-12 was insignificant. Days 12–15 had a significant statistical difference (p=0.001), days 15–19 not significant, and days 19–22 significant (p = 0.003). All significance was in favor of Group B, although the overall statistics were not significant. In terms of tolerance, Group B using the alginate semi-rigid bandage had a statistically significant difference in comfort on the second (p = 0.0004) and third (p = 0.024) weekends.

Although there was no significant difference in volume depletion for women from Group A to Group B, there was a statistically significant difference in the overall comfort of patients in Group B with the semi-rigid bandaging, which can directly impact the women’s quality of life during treatment for lymphedema.

The sample size was small (N < 100).

Some positive changes in women with lympedema rely solely on patient education and compliance with exercise. Patient education and physical therapy must be included in after surgery.