Pneumatic compression devices for the treatment of lymphedema

Lymphedema, if left untreated, or if treated inadequately, may lead to death if total obstruction of the lymphatic vessels occurs. The management of lymphedema is extremely variable in the medical profession, ranging from aggressive diagnostic procedures, which may aggravate the disease, to precipitous operations. Scattered between these two controversial extreme positions are quite a number of conservative methods, some of which are in conflict with the anatomy and physiology of the lymph vascular system and the pathology of lymphedema. This investigation first reviews how lymphedema can be treated with success, generally free of any side effects, using different approaches and techniques. As a second part of the research, pneumatic compression therapy is discussed in particular, and the results of some preliminary studies on four different pumps are reported. Desirable pump characteristics for effective treatment of lymphedema are discussed. The third and final aspect of the present investigation discusses a new approach which has been developed which may help determine if pneumatic compression therapy will be helpful on an individual basis. A mathematical model of the compression process of lymphedematous tissue has been developed, and combined with a proposed physical device which measures an applied force to a small area of skin and the subsequent displacement of the skin in order to predict the volume of fluid displaced in compression treatment. The goal is to be able to predict the degree of lymphedema reduction in a limb by predicting the volume of the translocated fluid from the limb during the compression therapy, and relating this to the pressures applied to the limb during the compression treatment.