Sequential Intermittent Pneumatic Compression (
SIPC) is an accepted method for treatment of peripheral
lymphedema. This prospective study evaluated the effect in 11 patients of a single session of
SIPC on both
lymphedema volume of the leg and
isotope lymphography (99Tc
dextran) before
SIPC (control) and 48 hours later after a 3 hour session of
SIPC. Qualitative analysis of the 2 lymphoscintigrams (LS) was done by image interpretation by 3 physicians on a blind study protocol. The LS protocol attributed an index score based on the following variables: appearance, density and number of lymphatics, dermal backflow and collateral lymphatics in leg and thigh, visualization and intensity of popliteal and inguinal lymph nodes. Volume of the leg
edema was evaluated by measuring limb circumference before and after
SIPC at 6 designated sites. Whereas there was a significant reduction of circumference in the leg after
SIPC (p<0.05), there was no significant difference in the index scores of the LS before and
after treatment. This acute or single session
SIPC suggests that compression increased transport of lymph fluid (i.e., water) without comparable transport of macromolecules (i.e.,
protein). Alternatively,
SIPC reduced
lymphedema by decreasing blood capillary filtration (lymph formation) rather than by accelerating lymph return thereby restoring the balance in lymph kinetics responsible for
edema in the first place.