Efficacy of Customized Pressure Device in Treating Lower Limb Lymphedema: An Observational Study

Shi Hun Tan; Teck Ree  Law; Salina Ibrahim

doi:10.64387/tjs.2025.274178

Authors

Shi Hun Tan Department of Plastic and Reconstructive Surgery, Hospital Sungai Buloh, Malaysia https://orcid.org/0009-0001-9967-1394
Teck Ree Law Department of Plastic and Reconstructive Surgery, Hospital Sungai Buloh, Malaysia
Salina Ibrahim Department of Plastic and Reconstructive Surgery, Hospital Sungai Buloh, Malaysia

DOI:

https://doi.org/10.64387/tjs.2025.274178

Keywords:

Lymphedema, Lower limb lymphedema, Lymph-ICF-LL questionnaire, LEL Index, Compreflex

Abstract

Objectives: Lymphedema is a chronic, progressive, debilitating disease characterized by the accumulation of protein-rich interstitial fluids in the subcutaneous tissue due to the failure of the lymphatic drainage system. This study sought to evaluate the efficacy of customized pressure devices in treating lower limb lymphedema.

Materials and Methods: 5 patients with lower limb lymphedema who are on customized pressure devices were recruited in this study. The severity of the lymphedema limb(s) was evaluated over 5 months based on both objective and subjective measures. An objective measure was evaluated using limb circumference at different levels measured from the heel, supplemented with the lower extremity lymphedema (LEL) index. Subjective measures were evaluated using the Lymphedema Functionality, Disability and Health Questionnaire for Lower Limb Lymphedema Reliability and Validity (Lymph-ICF-LL).

Results: The study group includes 4 male patients and 1 female between 40 and 55 years old. 2 patients have bilateral lower limb lymphedema, 2 patients have right lower limb lymphedema, and 1 patient has left lower limb lymphedema. Through the LEL index, all patients have significant improvement except 1 patient. Whereas utilizing the Lymph-ICF-LL questionnaire, clinically relevant improvements were observed in 1 patient in the mental function and mobility domain. Minor improvements were identified in others. No patient experiences reduced functionality. Most patients with lower limb lymphedema experienced a positive effect with the use of customized pressure devices.

Conclusion: Our study demonstrated the role of customized pressure devices in managing lower limb lymphedema. There is a significant decrease in LEL in 80% of our patients. Only 20% reported clinically significant improvement in their Lymph-ICF-LL score. Further evaluation is needed to determine the long-term outcomes of patients with lower limb lymphedema, especially regarding the long-term effects of customized pressure devices on LEL index and the ability to return to physical activities.

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