The ICC Compression Questionnaire: A Comprehensive Tool to Evaluate Compression Materials or Devices Applied in Subjects with Lymphedema or Chronic Venous Disease.

Background: Compression therapy is an important part of the treatment of patients with lymphedema or chronic venous disease. However, there is no validated questionnaire evaluating the effect of compression and its acceptance by the patient. Therefore, the aims of this study were to construct a questionnaire evaluating the effect of compression and its acceptance by the patient, that is, the Dutch ICC Compression Questionnaire (ICC-CQ), to investigate its reliability and validity, and to translate it into English. Methods and Results: Eleven experts in applying compression and 51 Dutch patients with experience of using compression were involved in the construction process. One part of the ICC-CQ has to be completed by the patient and evaluates seven domains. The other part has to be completed by the health care provider and comprises three domains. Reliability and validity of the final version was investigated in a new group of 79 Dutch-speaking patients with lymphedema or chronic venous disease, wearing compression garments (N = 52) or bandages (N = 27). Except for one domain, the Intraclass Correlation Coefficients for test-rest/interrater reliability ranged from 0.55 to 0.93. Cronbach's alpha for internal consistency ranged from 0.71 to 0.97. Eighty-nine percent of the patients fully understood the questionnaire indicating good face validity, and 87% found it complete indicating good content validity. Construct validity was considered good since 10 out of 11 hypotheses were accepted. Conclusion: The ICC-CQ is the first reliable and valid questionnaire evaluating different kinds of compression and the experience by patients with lymphedema or chronic venous disease.

Controlled, comparative study of relation between volume changes and interface pressure under short-stretch bandages in leg lymphedema patients.

BACKGROUND: Pressure loss under short-stretch bandages (SSBs) is a well-known phenomenon and is thought to be related to bandage relaxation and poor quality of application. AIM: The aim was to demonstrate that therapeutically intended volume reduction of the compressed leg is the most important cause for the loss of bandage pressure. DESIGN: This was an experimental, controlled comparative study. METHODS: In 20 patients suffering from lymphedema of the lower extremities and in 9 healthy persons, lower leg volume was measured by water displacement. After application of a pressure measurement device (Kikuhime) at the B1 region, SSBs were applied on one leg according to a standard protocol. Volume and pressure measurements were performed at 0, 2, and 24 hours in supine as well as standing positions. RESULTS: A significant reduction of leg volume is already achieved 2 hours after bandage application, both in lymphedema patients and in normal controls. A further volume decrease of the lymphedematous legs is observed in the following 24 hours after application of a new bandage (-290 mL). The volume reduction is associated with a significant loss of bandage pressure from initial values over 60 mmHg by 37 and 48% in controls and lymphedema patients, respectively. CONCLUSIONS: Inelastic, multilayer, multicomponent compression bandages lead to an immediate reduction of leg volume, both in lymphedematous and in normal legs. This therapeutically intended volume reduction seems to be the main reason for the fast decrease of the subbandage pressure. This study was supported by Lohmann & Rauscher, Ltd. Germany.