Adjustable compression devices for chronic oedema and lipoedema: purpose, selection and application

The lymphatic system acts as a mechanism to maintain fluid balance, immune response and nutritional absorption (Mortimer and Rockson, 2014), and dysfunction of this system leads to oedema. It has been estimated that between 3:99 and 28.76 per 1000 people are affected by chronic oedema, with lipoedema affecting 1:72 000 as a long-term condition (Moffatt et al, 2016; Wounds UK, 2017). Lipoedema is characterised by increased fat disposition within the subcutaneous layer and can lead to the development of excessive interstitial fluid in the dermal layer, which is the main characteristic of chronic oedema (National Lymphoedema Partnership, 2015; Wounds UK, 2017). Compression therapy is considered to be one of the mainstays in the management of chronic oedema and lipoedema. The application of compression therapy in the form of bandages, hosiery or adjustable compression devices (ACDs) is often used to manage lymphatic failure (International Lymphoedema Framework (ILF), 2012). This is usually alongside the modalities that enhance patient outcomes during the long-term management of the condition, such as simple lymphatic drainage (ILF, 2006).