Complete decongestive therapy versus compression bandaging alone in advanced secondary lymphedema

Ahmed M. Abdelrauf, Amal Mohamed Abd El Baky, Ahmed Salah El-Khodary, Hamed M Kadry, Eman Mohamed Othman


Ahmed M. Abdelrauf, Amal Mohamed Abd El Baky, Ahmed Salah El-Khodary, Hamed M Kadry, Eman Mohamed Othman – Complete decongestive therapy versus compression bandaging alone in advanced secondary lymphedema. Fizjoterapia Polska 2022; 22(3); 60-64

DOI: https://doi.org/10.56984/8ZG14224g

Abstract
Background. Secondary lymphedema results from a known insult to the lymphatic system. Worldwide, secondary lymphedema is more common than primary lymphedema. Compression therapy is the mainstay of management for all stages of lymphedema.
Purpose. To compare between the effectiveness of compression bandaging (CB) alone to the international standard treatment of (CDT) in patients with advanced secondary lymphedema.
Methods. Sixty patients of both genders with lower limb secondary lymphedema (stage II and III) aged from 40 to 55 years old, with body mass index (BMI) less than 35 and duration of illness ranged from 3-9 years were included in the study. They were randomly assigned into two groups of equal numbers. Group A: Thirty patients received CDT (Manual lymph drainage, CB, exercises, and skin care). Group B: Thirty patients received MCB using short stretch bandages alone. The treatment sessions consisted of twelve sessions, three times per week for a total duration of four weeks. The assessment of limb volume was done using water displacement method and truncated cone volumetric measurements (pre-treatment and after 12 sessions (post-treatment)).
Results. Within both groups, there was a significant reduction in water displacement volumetric measurements pre vs. post treatment in groups (A& B) p-value = 0.0001, p-value = 0.0001 respectively. As well, there was a significant reduction in truncated cone lower extremity volumetric measurements between pre and post treatment in groups (A & B) p-value = 0.0001, p-value = 0.028 respectively. However, there were no significant differences in the mean values of water displacement volumetric measurements and truncated cone mean volumetric values between both groups (p = 0.835, p = 0.397) respectively.
Conclusion. Compression bandaging alone is as effective as complete decongestive therapy in advanced secondary lymphedema.

Keywords
advanced secondary lymphedema, complete decongestive therapy, compression bandaging

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Effect of Polarized Light on Post Burn Hypertrophic Scars

Eman Mohamed Othman, Yasmeen Hamada Lotfy Mohamed, Ahmed Mohamed Kenawy, Rokaia Ali Zain El-Abedeen Toson

Eman Mohamed Othman, Yasmeen Hamada Lotfy Mohamed, Ahmed Mohamed Kenawy, Rokaia Ali Zain El-Abedeen Toson – Effect of Polarized Light on Post Burn Hypertrophic Scars. Fizjoterapia Polska 2021; 21(4); 116-121

DOI: https://doi.org/10.56984/8ZG20A5D9

Abstract
Background. Hypertrophic scar (HTS) formation after burn remains a major issue for burned patients and is considered a huge problem for clinicians because the hypertrophic scar is painful, reddish, elevated, pruritic, and aesthetically unacceptable. Purpose. To study the effect of polarized light therapy (PLT) on post burn HTS. Materials and Methods. Thirty patients complaining of HTS formation after thermal burn with ages ranged from 20 to 40 years shared in this study and were randomly distributed into two matching groups in number (15 patients for each group). Group A (Study group): received 10 min. PLT 3 sessions/week plus silicone gel sheet (SGS) kept for 12 hours/day, medical treatment such as (hydration creams and antihistamine drugs), and routine physical therapy (splinting, massage therapy, stretching exercises, and strengthening exercises) for 2 months. Group B (Control group): received SGS kept for 12 hours/day, medical treatment such as (hydration creams and antihistamine drugs), and routine physical therapy (splinting, massage therapy, stretching exercises, and strengthening exercises) for 2 months. Methods of evaluation included Vancouver scar scale (VSS) to measure four parameters of hypertrophic scar (height, vascularity, pigmentation, and pliability) and photographic method to allow for visual assessment of the scars. Results. Comparison between post-treatment and pre-treatment in the study group showed a significant decrease in height, vascularity, pigmentation, and pliability scores (p > 0.01). There was a significant decrease in height and pliability scores of the study group in comparison with that of the control group (p < 0.01), while there was no significant difference in vascularity and pigmentation between groups (p > 0.05). Conclusion. PLT is an effective, easy to apply, and non-invasive treatment modality in post burn HTS.
Key words:
Post burn hypertrophic scars and polarized light
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