Quéré, I., Presles, E., Coupé, M., Vignes, S., Vaillant, L., Eveno, D., . . . POLIT Study investigators. (2014). Prospective multicentre observational study of lymphedema therapy: POLIT study. Journal des Maladies Vasculaires, 39, 256–263.
All patients received DLT divided into two phases. The intensive treatment phase was administered over a one to three-week time period (daily treatment for at least five consecutive days), and the maintenance phase mainly was carried out by the patient and his or her family members at home. Limb volume was measured on days 5, 12, 19, and 195.
Observational, prospective, longitudinal cohort study
Initial intensive lymphedema treatment resulted in a 31% volume reduction, but the benefits were somewhat abolished when volume increased by 16.5% during the six-month maintenance phase. The only independent variable predictive of volume reduction after intensive therapy was the presence of previous intensive DLT. The most frequent adverse events were skin redness (18.4% of patients) and compression marks (42.3% of patients). Blisters requiring that treatment be stopped were uncommon (1.4% of patients).
There is a need for large, randomized trials to identify which components or combinations of components are most effective. There is a need to identify techniques to improve patient outcomes during the maintenance phase in trials for the long-term control of lymphedema.
Nurses should be aware of this intervention as a potential treatment for patients with lymphedema, making this an important point of education. The early identification of lymphedema using \"heaviness\" as a descriptor may help refer patients for treatment sooner. The fact that results may diminish after intensive treatment should be considered, and this could point to the importance of adhering to strict maintenance schedules and encouraging physical activity for long-term benefits.