Zhang, L., Fan, A., Yan, J., He, Y., Zhang, H., Zhang, H., . . . Xin, M. (2016). Combining manual lymph drainage with physical exercise after modified radical mastectomy effectively prevents upper limb lymphedema. Lymphatic Research and Biology, 14, 104–108.
To evaluate the efficacy of self-manual lymph drainage (MLD) added to physical exercise for the prevention of lymphedema and scar formation
Self MLD for a total 30 minutes, three sessions a day, after incision closure and suture removal was divided into three steps: Surgical incision scar (10 minutes a session), activate lymph nodes (10 minutes a session), ,stimulate lymph drainage (10 minutes a session). All patients were to continue active remedial exercises for six months following surgery. Women with breast cancer scheduled for surgery were randomly assigned to physical exercise (control) or self MLD plus exercise, with measurements for limb circumference and shoulder abduction recorded 24 hours before and after surgery at week 1, and at 1, 3, 6, and 12 months; evaluation of scar formation was conducted after suture removal at week 1, and at 1, 3, 6, and 12 months.
PHASE OF CARE: Multiple phases of care
Fewer patients in the MLD group had scar contracture (p < 0.05, MLD versus PE). Prevalence of upper limb lymphedema was lower in the MLD group at various time points (p < 0.05, MLD versus PE). Maximum shoulder abduction was better in the MLD group (p < 0.05, MLD versus PE).
The findings suggest that self-administered MLD with exercise was more effective in preventing lymphedema than exercise alone.
Patient education regarding the lymphatic system, self MLD, combined with physical exercise and adherence to the therapeutic routine may help in preventing scar formation, shoulder dysfunction, and upper extremity lymphedema.