Case Studies

The following has been excerpted from "Exploring The Use Of CircAid Legging In The Management Of Lymphoedema" by Eilish Lund, published in 2000 in the International Journal Of Palliative Nursing, Volume 6, No. 8, pages 383-391.

In the following case studies, use of a CircAid legging during the maintenance phase maintained and improved on the reduction achieved by DLT, thereby saving the patients from further DLT. The three patients described in the case studies below were selected from the author's caseload because the distal segments of their affected legs were very large. The case studies are not part of a controlled trial of the product, but report the results of treatment using a novel product.

Case I (30 year old male)

Case II (69 year old male)

Case III (78 year old female)

Conclusion

One of the indications for use of the CircAid legging is severe swelling of the distal segment of the leg. The rigid construction of the garment enhances the effect of the muscle pump. Adjustment of the Velcro straps during the day, as the leg volume decreases with exercise, helps maintain and gradually reduce the volume. The legging currently costs £95 plus tax in the UK. At the author's clinic, it was found that the legging needs to be replaced approximately every 9 months. This will of course be a consideration for large clinics with high hosiery costs.

However, in the three case histories presented here, the legging has improved quality of life, the limbs have improved steadily and the patients are very pleased with the results. Repeated sessions of DLT were not needed except in the case of Iris. A full treatment of DLT takes 90 minutes per leg, amounting to 22 hours for a 3-week course of treatment. Avoiding this treatment can save valuable time in clinics.

Contraindications for use of the CircAid are no different than those for compression hosiery:

• Infection and acute inflammatory episode
• Arterial insufficiency
• DVT
• Severe cardiac failure

Patient compliance appears to be good because of the ease of application and the support achieved. The fact that the results are good also encourages compliance. The limitations are that it does not address whole leg swelling and that the foot wrap is not easy to wear with shoes.

In the our clinic, we have begun to use the legging with less severe swellings of the lower leg in patients with lymphoedema secondary to cancer treatments --with good results. 

Reference cited in text: Mortimer PS (1995) Managing Lymphoedema. Clin Exp Dermatol 20:98-106.